A client is receiving instruction on a patient-controlled analgesia (PCA) pump. Which statement indicates the patient needs more instruction?

A client is receiving instruction on a patient-controlled analgesia (PCA) pump. Which statement indicates the patient needs more instruction?

• A. I can share my PCA button with a family member.
• B. I will push the button only when pain is severe.
• C. I should push the button only when I am awake.
• D. Only I should push the PCA button.

Answer: (D)

PCA safety hinges on keeping control with the patient while preventing misuse by others. The most important rule is that the PCA button is for the patient to press only, because dosing is tailored to the individual’s pain and response, and having someone else push the button can lead to overdose or inadequate monitoring of sedation and breathing. The statement that shows a need for more instruction is sharing the PCA button with a family member. Allowing someone else to press for the patient bypasses the patient’s own pain assessment and the safety checks built into the device and team monitoring, which can put the patient at risk. Other points can be appropriate with proper guidance: using the PCA to request relief when pain begins (not waiting until pain is severe) helps maintain comfortable pain levels and reduces the risk of breakthrough pain; pressing the button only when awake is sensible because response and monitoring are part of safe use; and the idea that only the patient should push the button aligns with the intended purpose of PCA.

PCA safety hinges on keeping control with the patient while preventing misuse by others. The most important rule is that the PCA button is for the patient to press only, because dosing is tailored to the individual’s pain and response, and having someone else push the button can lead to overdose or inadequate monitoring of sedation and breathing.

The statement that shows a need for more instruction is sharing the PCA button with a family member. Allowing someone else to press for the patient bypasses the patient’s own pain assessment and the safety checks built into the device and team monitoring, which can put the patient at risk.

Other points can be appropriate with proper guidance: using the PCA to request relief when pain begins (not waiting until pain is severe) helps maintain comfortable pain levels and reduces the risk of breakthrough pain; pressing the button only when awake is sensible because response and monitoring are part of safe use; and the idea that only the patient should push the button aligns with the intended purpose of PCA.