Pain Management Devices Monitoring Practice Test

A 73-year-old client with chronic pain has a transdermal fentanyl patch in place. The client reports using an electric heating pad on the shoulder where the patch is applied. Vital signs: temperature 98.9°F (37.2°C), heart rate 68/min, blood pressure 108/62 mmHg, respiratory rate 10/min, oxygen saturation 93% on room air; pain rating 2/10; client is sleepy. Which assessment finding requires immediate intervention with a transdermal patch?

A 49-year-old client is using a PCA pump with hydromorphone after hernia repair. Assessment: the pump alarm indicates “dose limit reached”; vital signs: heart rate 92/min, blood pressure 138/84 mmHg, respiratory rate 18/min, oxygen saturation 98% on room air; pain rating 9/10; client is alert and requesting more medication. Which finding indicates a problem with the PCA pump?