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A postoperative client returned from the postanesthesia care unit (PACU) this morning with a patient care analgesia (PCA) pump running with a basal rate of hydromorphone (Dilaudid). The nurse assesses the client's vital signs as BP 90/60 mm Hg, heart rate 96 beats/min, and respiratory rate of 10 breaths/min. What next action should the nurse take?a. Document the findings and reassess in 2 hours.b. Turn off the pump and give naloxone (Narcan) intravenous push med (IVP) per protocol.c. Assess the client's pain level on a 10-point scale.d. Call the rapid response team.

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1. A postoperative client returned from the postanesthesia care unit (PACU) this morning with a patient care analgesia (PCA) pump running with a basal rate of hydromorphone (Dilaudid). The nurse assesses the client's vital signs as BP 90/60 mm Hg, heart rate 96 beats/min, and respiratory rate of 10 breaths/min. What next action should the nurse take?

a. Document the findings and reassess in 2 hours.

b. Turn off the pump and give naloxone (Narcan) intravenous push med (IVP) per protocol.

c. Assess the client's pain level on a 10-point scale.

d. Call the rapid response team.





 
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