Postoperative Pain Management for PRN Medications - myassignmenthelp

Question: Discuss about thePostoperative Pain Management for PRN Medications. Answer: Lisa, a 38-year-old mother in the hospital is in pain that keeps on increasing. The pain initially was due to perforated abdomen that is caused by diverticulitis (Angenete, Thornell, Burcharth, Pommergaard, Skullman, Bisgaard ... Rosenberg, 2016). This is the formation of pockets around the gut which become inflamed. Lisa, underwent surgery around the midline and this incision is the cause of her pain (Reddi Curran, 2014). The cutting open of tissues and skin and suturing back causes stimulation of pain receptors leading to hypersensitivity to pain. The inflammation process that follows damage to tissues also results to the unpleasant feeling after the surgical procedure. The goal or outcome expected regarding Lisas problem is to ensure she verbalizes and demonstrates decreased sensation of pain rating it below 2 in a scale of 1-10 at the end of the shift. This will be demonstrated by the patient having no facial grimaces and is able to sit up in bed without complaining of pain at the surgical site (Chou, Gordon, de Leon-Casasola, Rosenberg, Bickler, Brennan... Griffith, 2016).v The nursing care for Lisa is educating her to remain calm and relaxed in bed. the nurse should assess the pain level and rate it in a scale of 1-10. Nurse should educate the patient on the use of PRN medications (paracetamol and diclofenac). The nurse should assess the vital signs of the patient (Cardona-Morrell et al., 2016). Give emotional support to the patient. Educate on the use of patient controlled analgesia. The assessment of pain levels should be during motion and when the patient is resting. Pain assessment is necessary as it enables the nurse to know the severity and hence choose the appropriate regime for management. The pain should be assessed after every two hours. The vital signs; pulse, respiration, blood pressure and temperature. When one is in severe pain, the pulse rate tends to increase as well as breathing rate, blood pressure and temperature. This is because pain activates the sympathetic nervous system hence a rise on the blood pressure, pulse and respirations, this increases metabolism hence increased temperature. (Arbour, Choinire, Topolovec-Vranic, Loiselle Glinas, 2014). Emotional support enables patient to relax and relieve stress. PRN medications and patient controlled analgesia ensure patient is pain free as she takes medications only when she has pain sensation. It also helps prevent addiction to the analgesics (Stubbs, 2014). Advising the patient to remain calm e nables her not to irritate the injured tissue hence reducing pain stimulation. Patient controlled analgesia involves educating patient on the infusion pump use and use of oral medications as soon as she needs them. In the evaluation, the nurse will assess the quality of the nursing interventions to ascertain the intended goal. The evaluation helps to monitor the patient progress, checking for improvements and deciding on the need to re plan in case the prior plan is not bringing out the intended goal. The nurse will ask the patient the extent of pain and rate it in a scale of 1-10. The nurse will assist the patient in sitting up and assess the pain level by observing the facial grimaces, whether Lisa is guarding the site or is complaining of increasing pain sensation. References Angenete, E., Thornell, A., Burcharth, J., Pommergaard, H. C., Skullman, S., Bisgaard, T., ... Rosenberg, J. (2016). Laparoscopic lavage is feasible and safe for the treatment of perforated diverticulitis with purulent peritonitis: the first results from the randomized controlled trial DILALA.Annals of surgery,263(1), 117. Arbour, C., Choinire, M., Topolovec-Vranic, J., Loiselle, C. G., Glinas, C. (2014). Can fluctuations in vital signs be used for pain assessment in critically ill patients with a traumatic brain injury?Pain Research and Treatment,2014. Cardona-Morrell, M., Prgomet, M., Lake, R., Nicholson, M., Harrison, R., Long, J., ... Hillman, K. (2016). Vital signs monitoring and nursepatient interaction: A qualitative observational study of hospital practice.International journal of nursing studies,56, 9-16. Chou, R., Gordon, D. B., de Leon-Casasola, O. A., Rosenberg, J. M., Bickler, S., Brennan, T., ... Griffith, S. (2016). Management of Postoperative Pain: a clinical practice guideline from the American pain society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' committee on regional anesthesia, executive committee, and administrative council.The Journal of Pain,17(2), 131-157. Gordon, D. B., de Leon-Casasola, O. A., Wu, C. L., Sluka, K. A., Brennan, T. J., Chou, R. (2016). Research gaps in practice guidelines for acute postoperative pain management in adults: findings from a review of the evidence for an American Pain Society Clinical Practice Guideline.The Journal of Pain,17(2), 158-166. Reddi, D., Curran, N. (2014). Chronic pain after surgery: pathophysiology, risk factors and prevention.Postgraduate medical journal,90(1062), 222-227. Stubbs, L. N. (2014). Patient Controlled Oral Analgesia Delivery Device Promising Technology to Improve Pain Control in Acute Care Settings.On-Line Journal of Nursing Informatics,18(3).