When teaching a competent postoperative client about a patient-controlled analgesia (PCA) pump, the nurse should include which instructions to the client? Select all that apply.

PCA pumps have opioid medications infusing. Opioids can have an effect on the parasympathetic nervous system causing nausea, vomiting, and an inability to void and defecate; these occurrences need to be reported. The nurse must be kept informed about the pain relief achieved by the client and if there is any breakthrough pain. The client needs to be instructed to push the button before the pain becomes too great. Because the client is competent and there is a basal dose being administered, there is no need for the family to push the buttons for pain relief. In addition, no one other than the client should touch the pump unless instructed to do so.