A Nursing Plan for Pain Management

2. Address Mrs. Thomas’s Physical pain and decline. Explore Mrs. Thomas’s attitudes and feelings about the use of narcotics. Some patient’s choose to forgo pain medications because they fear decreased alertness and want presence with family and friends. Non-narcotic and non-sedating medication options should be explored and discussed. Help Mrs. Thomas verbalize her fears about the medications. Explain the difference between addiction and dependence. Explore Mrs. Thomas’s openness to alternative methods of pain control such as visualization, music therapy, self-hypnosis and mediation. Encourage her to listen to her body by resting when needed and participating in life when she has the energy. Mr. and Mrs. Thomas both require education about palliative care options for management of symptoms associated with her disease.

There are two different options evident concerning Mrs. Boswell’s treatment options. While considering both options, it is important to teach the family in depth the effects of the dialysis treatments along with her other chronic illnesses. The first option is to discontinue dialysis treatments and place her in a hospice facility. In hospice care, the goal is of focusing on minimizing pain and suffering, rather than to cure. Going to hospice care would allow Mrs. Boswell to forgo her stringent dialysis treatment and provide her comfort measures allowing her to endure her illnesses with optimal pain reduction. Along with treating the sole patient, hospice care allows for family to be there throughout the whole process while being provided bereavement support. The book p. 234 says that nurses play a pivotal role when tending to patients with notable poor outcomes, bringing attention to caring and not curing.

In order to diagnose this patient with this bacterium, I would place an order for a blood culture. Blood cultures are indicated in patients with sepsis, severe skin and soft tissue infections, or unstable vital signs; example massive organ failure. Blood cultures

This condition can be treated at anytime by an antibiotic like penicillin. Since this condition can damage the organs, it is better to get it treated sooner than later. It is also important to keep going back to the doctors to get blood work done repeatedly to make sure that the infection is totally cleared up.

Vivian Bearing did not show a lot of kindness or compassion to her own students as she did not think that it was important. Now as her death is approaching she comes to realize that is what she has been missing. Her nurse Susie patiently explains the treatment plan to Vivian in terms that she can understand; including the DNR (do not resuscitate) and that it was her decision, Susie allowed Vivian some control over her life by giving her this choice while she fought for her dignity. As her nurse strives to provide her with compassion and empathy this is important to Vivian in her final days as compassion is connected to our human spirit; as she was approaching death (Frost, 1999, p127). Patients often experience quicker healing rates when they receive compassion as opposed to those who do not (Dossey, 2007). Susie told Vivian when she was semi conscious that they were putting a catheter in; even though Doctor Jason said :why are you bothering?” Some people, such as nurse Susie, will go out of their way to make others comfortable and put the patients need before there own, we just have to be mindful of emotional burnout if our own needs are not being met (Brehony, 1999, p

Treatment for infected people involve antibiotics, steroids, intensive care, and droplet precautions. Prophylactic antibiotics are usually given to prevent the spread of the disease to those in close contact of the infected people.

The movie “Wit” is a great educational tool for healthcare professionals in terms of dealing with terminally ill patients. It teaches that nurses and medical professionals should always remember that their patients are not a case nor illness nor experiment but rather human beings with souls and pains. Palliative care is one of the most disputed issues of worldwide importance. While bureaucrats in different countries are making laws on the use of palliative drugs, patients with excruciating pains learn how to “take deep breaths and be strong” (Nichols & Brokaw, 2001). That is what nurse Susie Monahan from “Wit” advises her dying patient Vivian Bearing suffering from unbearable pains due to stage IV ovarian cancer after eight painful rounds

My main priority would be to dehydrate the patient with a normal saline IV, then administer drugs for her pain, the dilaudid that the physician ordered for her. Then I would administer 5 ml’s of Vancomycin to treat the C. Diff.

Primary treatments include antibiotic therapy, Fluid resuscitation, and crystalloid. Potential treatments depending on patient status include vasopressors and steroids, ventilator, renal dialysis, blood transfusion, and surgery.

Nursing assessment is a substantial way of gathering physiological, psychological, spiritual, and emotional condition of the patient. It creates a whole picture of an individual and assist the health care providers to formulate a diagnosis. Assessing the comfort of the patient is equally important as taking the blood pressure or temperature. Pain is the fifth (5th) vital sign that is subjective in nature when performing an assessment of a patient. Various studies were conducted in finding the most appropriate evidence-based nursing practice in assessing and managing the pain of a cognitively impaired patient, whether it is acute or chronic or the underlying cause is cancer or post-operative incision. As emphasized by Song, Eaton, Gordon, Hoyle, and Doorenbos (2015), it is vital to ensure that “pain management is based on the best evidence” (p. 456). Perhaps knowing the causes of inability to assess and manage the pain in a cognitively impaired patient would give a clearer understanding of the practice.

As a hospital, quality care should be a priority for patients that are going to be treated for a sickness, or any type of procedure that is going to take place. A lot of times a patient gets an infection while they were at the hospital, on top of being treated for what they original came in for. Health facilities should be environments of healing, which they are, but they also have tons of various types of germs and infections, which grasp onto individuals that have weak immune systems/are sick. Some infections that are at hospitals are Tuberculosis, VRE, VAP, C-Diff, UTI, and MRSA. Preventive measures to stop the spread of the infections is lacking tremendously in the work and aim to provide safety for all patient’s health. The work

The current health situation should be explained in a non-technical way so the patient (if possible) family, and or valid surrogate can understand every aspect. The physician should also help them understand when there is no hope for recovery. Most often the organs are no longer functioning, or there is little to no brain activity; at this point suffering potentially outweighs the probability of recovery. Medical teams most often realize that the focus should be on comfort, rather than extending a dying life. This decision comes with a great deal of uncertainty, and will always be hard, no matter what age of the patient, or the circumstances. Kathryn Kosh, MD explains that, “Ready access to advanced modern technology has changed death from an event to a process… Defying death requires payment [in the form of] pain and discomfort or in an unacceptable decline in the quality of life.” Often times physicians will not prescribe treatment in the first place knowing that this option will not benefit the patient, prolong suffering; and will likely end in termination anyway. Therefore, allowing the nature of the illness or injury to take its own course of action. Another point of interest regarding this topic is that medical teams realize in most cases, that providing an ethical and dignified death can be just as rewarding as administering aggressive measures to save a

This essay will aim to look at the main principles of cancer pain management on an acute medical ward in a hospital setting. My rational for choosing to look at this is to expend my knowledge of the chosen area. Within this pieces of work I will look to include physiological, psychological and sociological aspects of pain management.

Ineffective breathing pattern related to decreased oxygen saturation, poor tissue perfusion, obesity, decreased air entry to bases of both lungs, gout and arthritic pain, decreased cardiac output, disease process of COPD, and stress as evidenced by shortness of breath, BMI > 30 abnormal breathing patterns (rapid, shallow breathing), abnormal skin colour (slightly purplish), excessive diaphoresis, nasal flaring and use of accessory muscles, statement of joint pain, oxygen saturations of 85-95% 2L NP, immobility 95% of the day, and adventitious sounds throughout lungs (crackles) secondary to CHF, hypertension, pain caused by gout and arthritis, and obesity

As an administrator I would need to take into consideration the patient’s autonomy, autonomy is recognizing an individual’s right to make his/her own decisions about what is best for them regarding their health care (Pozgar, 2012). The patient’s rights always should be considered before any decisions are made by any other family members. In this scenario it is clear that the patient is unable to make any decisions, the patient has suffered a serious brain damage, and although it is not complete brain death, we must determine how to proceed.