A client receiving fentanyl via PCA reports increased pain and the nurse adjusts the PCA settings. After making the prescribed changes, the nurse should initially:

A client receiving fentanyl via PCA reports increased pain and the nurse adjusts the PCA settings. After making the prescribed changes, the nurse should initially:

• A. verify the settings with a second nurse
• B. educate the client about the medication's side effects
• C. reposition the client for nonpharmacological relief
• D. reassess the client's pain level

Answer: (A)

Verifying PCA pump settings with a second nurse is the safety-first step whenever you adjust opioid delivery. Fentanyl via PCA can cause serious harm if programmed incorrectly, so a second clinician’s double-check ensures the bolus dose, lockout interval, basal rate, and any maximums match the physician’s orders. Once the settings are confirmed, you can reassess the patient’s pain and monitor for adverse effects. While education, nonpharmacologic relief, or further pain reassessment are important, they come after ensuring the device is correctly programmed.

Verifying PCA pump settings with a second nurse is the safety-first step whenever you adjust opioid delivery. Fentanyl via PCA can cause serious harm if programmed incorrectly, so a second clinician’s double-check ensures the bolus dose, lockout interval, basal rate, and any maximums match the physician’s orders. Once the settings are confirmed, you can reassess the patient’s pain and monitor for adverse effects. While education, nonpharmacologic relief, or further pain reassessment are important, they come after ensuring the device is correctly programmed.