Question

An oncology surgical client’s pain is being controlled with patient control analgesia (PCA) Morphine Sulfate 30mg/30mL concentration. The healthcare provider has ordered a maximum dose of 20mg/4hours, patient control of 2mL/dose, and lock out of 12 minutes. The client has pushed the device eight times in 4 hours. How many milligrams did the client receive? ? A. 20 mg ? B. 16 mg ? C. 10 mg ? D. 4 mg

Short answer

Answer: B. 16 mg

Step-by-step solution

Determine the dose for each push

The patient-controls dose is 2mL/dose. We'll find out how much milligrams each push delivers by using the given concentration of Morphine Sulfate, which is 30mg/30mL.

Calculate the milligrams per dose

Using the given concentration, we can calculate the amount of milligrams the patient receives per dose as follows: Dose per push (mg) = (Dose per push (mL) * Concentration (mg/mL)) Dose per push (mg) = (2 mL * (30 mg/30 mL))

Simplify the equation

Now let's simplify the equation to find the dose per push in milligrams: Dose per push (mg) = 2 * 1 = 2 mg So, each push delivers 2 milligrams of Morphine Sulfate.

Determine the total number of milligrams received

The client has pushed the device eight times in 4 hours. To find the total number of milligrams received, we can multiply the dose per push (mg) by the number of times the client pushed the device: Total milligrams received = Dose per push (mg) * Number of pushes Total milligrams received = 2 mg * 8

Calculate the total milligrams received

Now let's calculate the total milligrams received: Total milligrams received = 16 mg The client received a total of 16 milligrams of Morphine Sulfate in 4 hours. Therefore, the correct answer is ? B. 16 mg.

Key concepts

Patient-Controlled Analgesia

When managing pain, especially in postoperative or cancer patients, Patient-Controlled Analgesia (PCA) is a valuable method. PCA allows individuals to administer their own pain relief by pressing a button to release a predetermined dose of analgesic, usually an opioid like Morphine Sulfate. It’s important to understand that PCA devices are programmed with safety features—maximum dosage limits over a time period (e.g., 20mg/4hours) and a lockout interval (e.g., 12 minutes) to prevent overdose. Patients can administer a dose, often set in milliliters (mL), within these safety parameters, ensuring that they have control over their pain management while minimizing the risk of medication errors.

The exercise you're referring to exemplifies the calculation involved in a PCA situation where a patient is using Morphine Sulfate to control their pain. Understanding PCA is significant for both patients—who gain autonomy in pain management—and health care providers—who need to ensure the safe and effective use of PCA devices.

Dosage Calculation

Dosage calculation is a cornerstone of pharmacology nursing, crucial for safe patient care. Nurses must be proficient in converting and calculating doses to ensure that patients receive the correct amount of medication. This process often includes converting units, such as milliliters to milligrams in the case of a liquid medication like Morphine Sulfate, and calculating total drug intake over a specific period.

In the given scenario, determining the single dose and then the total intake over four hours demonstrates the nuts and bolts of dosage calculation. It is essential to grasp these principles to avoid under-dosing, which may lead to inadequate pain control, or overdosing, which can cause severe adverse effects. Competency in dosage calculation is not only a matter of passing an exam but a fundamental skill that directly influences patient outcomes.

For educational purposes, step-by-step solutions like the one provided can be greatly beneficial. They illustrate how to work through the problem methodically, reinforcing the importance of accuracy in real-world nursing practice.

Pharmacology Nursing

Pharmacology nursing is a domain that integrates the science of pharmacology with nursing care to achieve optimal therapeutic outcomes. Nurses in this specialty must understand drug mechanisms of action, therapeutic uses, potential side effects, and interactions with other medications. The role also involves educating patients about their medications, monitoring drug effects, and making dosage recommendations as needed.

Understanding pharmacology concepts is crucial in activities such as using PCA, where knowledge of opioid analgesics, their concentration, and safety parameters guide practice. For example, Morphine Sulfate must be managed carefully due to its potency and the risk of respiratory depression. The inclusion of pharmacology in NCLEX-RN exam preparation is not accidental—it ensures that future nurses are equipped with the expertise needed to manage medications effectively and recognize pharmacological principles in clinical scenarios.

Learning resources that explain how to apply pharmacological knowledge to practice scenarios, as shown in the PCA dosage calculation exercise, are invaluable for nursing students preparing for the NCLEX-RN exam.