HNN227 Final: COMPLEX WOUND DRESSINGS AND PCA
1 Jun 2018
School
Department
Course
Professor
HNN227
COMPLEX WOUND DRESSINGS AND PCA
1
DESCRIBE, PERFORM AND DOCUMENT CARE FOR A PATIENT REQUIRING PATIENT-
CONTROLLED ANALGESIA FOR PAIN
PCA is delivered via a pump device that infuses medications either continuously, intermittently, or allows
the patient to self-administer small doses of medication on demand (or a combination of these three). It
can be given intravenously, subcutaneously or via epidural space.
Indications:
- For patients with acute and chronic pain
- If an alternate and safer method for giving intravenous opioids in a ward is required
- Enhances pain control by maintaining a constant level of analgesia in the blood
- Allowing the patient to control their own analgesia
- If they have altered mentation, limited respiratory reserve, haemodynamic instability or sleep
apnoea
Risks:
- Administering incorrect medication (not following 5 rights)
- Wrong additive label
- Overdosing patient
Equipment:
- Medication order
- Medication
- Syringe
- Saline
- Syringe cap
- Sterile needle
- Kidney dish
- Additive label
- PCA pump or syringe driver (and its tubing)
- Sharps container
- Alco wipes
Method:
1. Assess the patient for suitability of PCA (must be mentally alert, able to comply with instructions to
use the PCA)
2. If appropriate, assess pt’s cannula site (looking for inflammation, redness, swelling or phlebitis),
their allergies, medication chart, pain assessment and baseline vital signs
3. Collect equipment
4. Perform hand hygiene
5. Follow the 5 rights for administration (checked with another nurse)
6. Check against medication order sheet how much and when
7. Draw up the correct amount of saline into syringe (checking dates on all saline)
8. Then attach drawing up needle and draw up analgesia (checking dates and amount with other
nurse)
9. Fill out additives label and attach to syringe with other nurse
10. Attach and prime the extension tubing
11. Clamp the extension line
12. Take equipment to the patient and check their 3 identifiers and UR number
13. Place syringe into driver and set the syringe size, continuous dose, bolus dose and delay keys, and
lock the driver (check with other nurse and against medication order) (can be interchanged with 12)
14. Explain how to press the button to administer medication when they feel in pain
15. Hand hygiene and put on gloves and wipe cannula with alco wipes
16. Attach to cannula
17. Unclamp tubing and begin infusion
18. Observe the patient (vital signs, consciousness, pain level etc.)
19. 2 hourly monitoring is required for the first 24 hours
20. Document
21. Hand hygiene
DESCRIBE, PERFORM AND DOCUMENT CARE FOR A PATIENT REQUIRING A COMPLEX
WOUND DRESSING
PACKING A WOUND
Indications:
- Artificially holds the wound open, which prevents premature closing of the top of the wound
before granulation has occurred at the base
- Absorb excess exudate
Document Summary
Describe, perform and document care for a patient requiring patient- Pca is delivered via a pump device that infuses medications either continuously, intermittently, or allows the patient to self-administer small doses of medication on demand (or a combination of these three). It can be given intravenously, subcutaneously or via epidural space. For patients with acute and chronic pain. If an alternate and safer method for giving intravenous opioids in a ward is required. Enhances pain control by maintaining a constant level of analgesia in the blood. Allowing the patient to control their own analgesia. If they have altered mentation, limited respiratory reserve, haemodynamic instability or sleep apnoea. Administering incorrect medication (not following 5 rights) Pca pump or syringe driver (and its tubing) Describe, perform and document care for a patient requiring a complex. Artificially holds the wound open, which prevents premature closing of the top of the wound before granulation has occurred at the base.
