While caring for a patient who is on a continuous passive motion machine (CPM) after a total knee replacement, a nurse notices that the patient is grimacing. Pain medication is not due for 2 hours,
but the CPM machine is supposed to continue for another 20 minutes. The best action by the nurse is to
1. Call the physician for additional pain medication.
2. Encourage the patient to bear it for 20 minutes longer.
3. Instruct the patient to tense and then relax his or her leg muscles.
4. Teach the patient relaxation techniques.
Question 2
A student nurse is providing care for a patient who is returning from the recovery room after a total hip replacement. During an initial assessment, the student notes serosanguineous drainage on the dressing. The student should
1. Remove the dressing and assess the wound site.
2. Draw a line around the drainage and write the time, date, and his or her initials on the dressing.
3. Notify the nursing instructor of the finding.
4. Document the finding in the chart.
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