Pain Case Study Discussion Questions
In the case study presented by the patient after falling off from the bed when going to the bathroom at his home, the priority assessment is required to establish his medication plan. The priority assessment will be identifying vital signs, which are the baseline observations that are recorded on flowsheets immediately; the nurse visits the patient at home. In the case of the patient presented in the case study, the assessment of vital signs is completed as indicated. The next priority assessment is determining the level of pain to help in prescribing drugs that the patient would use to relieve it. Mental health and emotional response are the last part of the assessment process. Mental health focuses on assessing whether the pain or the condition of the patient has affected cognitive behaviors and emotional responses to the medication.
Physical assessment is also required for the patients to obtain information that will allow the health care providers to acquire a complete evaluation. The observation to be made will include the rate of palpation, percussion, and auscultation. The decision made by the clinicians should be used to decide on the extent of the assessment needed (Hinderer, DiBartolo & Walsh, 2014). The second one is the primary assessment, which should be carried out on the airways, breathing rates, circulation of the blood in the body, and disability caused by the old age, following the fact that the patient does not share his health status with any of the family members. The assessment process aim at providing the nurse with adequate information on the overall health of the patient to ensure that the medication plan scheduled is effective and evidence-based. The third assessment is the information obtained from the family members since it would help healthcare providers to involve them when making a medical decision about the patient and determine whether it could be suitable for the patient to proceed to the sugary on the day of admission. The last assessment is doing early surgery after an accident, especially for aged individuals, which is quite recommended because it improves mobility and mortality outcomes.
The significance of the patient’s behaviors and changes in vital signs is that the patient, due to his pride, does not want to express that he is in pain and wants to show that he can manage it himself with mild medicines. Failure to express his feelings has made the patient in the case study to deteriorate his health. Despite experiencing severe pain, the patient refuses to change their position when he was requested by the nurses to do so. The purpose of assessing vital signs is to establish a starting point on hospital admission, clinical care, professional office, or other encounters with health care providers. A nurse or any other healthcare professional may record vital signs of the patient, which offers essential information to be used during the surgical plan. The vital signs will include temperature measurement, respiratory evaluation, pulse, and blood pressure, providing essential information about a patient’s state of health.
The nurse might try to get an accurate pain assessment from the patient by applying specific PQRST assessment questions. Provocation or palliation is where the nurse gets to know the step the patient usually takes when the pains start (Hinderer, DiBartolo & Walsh, 2014). The question will ensure that the patients provide accurate information on the way he handles illnesses when he is lone. The next step is looking at the quality or the quantity of the feeling the patient get after trying to stop it. From the question, it creates rapport for the patient to participate in the discussion, and in doing so, the nurse gets to know the pain conditions of the patient. The nurse also can ask the part to identify the region where he experiences severe pain when touched and understand the severity scale of it. Further, the timing of the pain can help a nurse to obtain accurate information concerning the pain experienced by the patient.
Based on the assessment information obtained, the most appropriate pain medication for the patient at this time is pain management, as it will help prevent undertreatment process. Through pain control, it will improve both physical and psychological patient outcomes as it boosts the immune system for older people (Laranjeira & Quintão, 2014). Also, pain management controls problems like depression and anxiety, which might be accompanied by the severity of the condition that patients might be undergoing.
The nurse should teach the patient that the medications prescribed by the physician are for pain relievers would help him to get relief of pain and will make him comfortable. Also, it will ease him to do his daily activities as he used in the past, following the fact that the patient does not stay with anyone. The patient needs to understand that pain management is essential in keeping them to do things they enjoy. Pain is what is causing the patient from talking and spending time with others, affecting his mood and ability to thing.
Deep breathing, guided imagery, and musical therapy are non-pharmacologic measures the nurse could use to reduce the patient’s pain in addition to the use of pain medication given to them. Deep breathing is achieved by finding a comfortable place where the patient can sit or lie down, place one hand on his stomach right above the belly button and breathe deeply as he makes it longer and shorter. Guided imagery reduces pain through relaxation techniques where the patient used his imagination to picture time, a place, or person that makes him feel relaxed. Musical therapy work in the management of chronic pain by providing sensory stimulation that evokes a response in the patient.
- Hinderer, K., DiBartolo, M., & Walsh, C. (2014). HESI Admission Assessment (A2) Examination Scores, Program Progression, and NCLEX-RN Success in Baccalaureate Nursing: An Exploratory Study of Dependable Academic Indicators of Success. Journal Of Professional Nursing, 30(5), 436-442. doi: 10.1016/j.profnurs.2014.01.007
- Laranjeira, C., & Quintão, C. (2014). EPA-0774 – Improving the quality of care through pain assessment and management. European Psychiatry, 29, 1-19. doi: 10.1016/s0924-9338(14)78120-9