Marilyn Hughes is a 45-year-old female who suffered a left mid shaft tibia-fibula fracture while slipping on icy stairs this morning. She was taken to surgery for an open reduction with internal fixation (ORIF). She returned from surgery 1345 hours. She has a below the knee splint dressing Vital signs have been stable and neurovascular checks have been within normal range. She has an intravenous of Normal Saline infusing at 75 mL/hour. She is tolerating liquids well without nausea. Her diet could probably be advanced to regular dinner for tonight. She has a family member at the bedside who has been with her throughout the day. She began complaining of pain shortly after returning from surgery. She has a PCA in for pain management with a background infusion of 1 mg/hr of Morphine, with a bolus of 1 mg per bolus with lockout interval of 15 minutes. She is now on every 30 minute post-op vital signs. Last vital signs were blood pressure: 130/82, heart rate: 88, respiration rate: 16 oxygen saturation 92%.
Expert Solution Preview
Question: What is the recommended initial PCA settings for postoperative pain management?
Answer: The recommended initial PCA settings for postoperative pain management include a background infusion of 1 mg/hr of Morphine, with a bolus of 1 mg per bolus with lockout interval of 15 minutes. This is consistent with the settings given for Marilyn Hughes in the provided case study.
Introduction: Postoperative pain management is an essential aspect of patient care, and patient-controlled analgesia (PCA) is a common method used for this purpose. PCA allows patients to self-administer pain medication within set limits, giving them some control over their pain management while minimizing the risk of overdose. When initiating PCA, it is important to set appropriate limits based on the patient’s needs and medical history.
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