...used the Amarillo College Library Network and CINAHL database on campus and opened as many articles that I believed would aid in my research. The words I used for searching were: TKR, total knee care, and managing total knee replacement. The contributing factors gave me the articles that related to my patient that I had cared for in clinicals. These searches took me to the information that I was in need of for my paper. Turner’s (2011) primary focus was about care prior to surgery, during, post-operatively, and nursing care. Although this article is a basic overview from preoperative care to discharge, her agenda is clear that importance of risk factors, assessments and labs should be monitored. The main emphasis of this article is to follow assessments and interventions post operatively. Starting with vital signs and trending them as well as pain status and level of consciousness....
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...Running Head: Postoperative Pediatric Pain Management Postoperative Pediatric Pain Management: A Multidisciplinary Concept Analysis Postoperative Pediatric Pain Management: A Multidisciplinary Concept Analysis Acute pain following a surgical procedure is one of the most common stimuli experiences by pediatric patients. Pediatric postoperative pain management has long been overlooked and treated differently than adult pain management. There tend to many misconceptions when it comes to pediatric pain management stemming from the belief that children do not experience pain the same way as adults. Since the pediatric population is not legally allowed to make medical decisions, guardians must make these decisions for them. Postoperative pain in the pediatric patient may be hard to assess and therefore healthcare professionals have begun to involve family members and caregivers in the pain management process. Pain can stem from many sources and thus must be holistic, involve multiple disciplines, provide education and apply to each individual patient. In practice, advocacy for these young children is important in helping them and their families understand about the situation and make education decisions on how to proceed with care. The concept of postoperative pediatric pain management must be analyzed to help resolve these misconceptions and not ignore the population who at times cannot speak for themselves. Review of Literature After a surgical procedure, the pediatric...
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...Treatment Types for Oncologic Pain James Skelton Mercy College of Health Sciences Treatment Types for Oncologic Pain Nearly all those who are diagnosed with cancer will have some kind of pain associated with the disease process. This pain may be visceral, neuropathic, procedural, or psychological in nature. This paper is a discussion of the different procedural guidelines that are currently used by the World Health Organization in the treatment of oncologic pain. This is also a look at alternative therapies that may be used in conjunction with the previously accepted pharmacological treatment of Western medicine. Article Summary One The article written by Fielding, Sanford, and Davis (2013) is a review of the current step-by-step guidelines the WHO has had in place for some time along with a comprehensive assessment of pain, the use of opioids and their adverse affects, the role of adjuvants, and non-pharmacological means of cancer pain treatment. The WHO bases its algorhythm on simplistic, broad categories such as mild, moderate, and severe pain. The article itself is geared towards nurses because they have a unique role in advocating for the patient. The WHO has had a three step analgesic ladder that it has used as a basis for cancer pain treatment for nearly 30 years now. Fielding, et al. (2013), stated that health professionals need to go beyond this three step ladder that focuses primarily on physical pain. Cancer pain is not just a physical but a biopsychosocial...
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...omission of names (Nursing and Midwifery Council (NMC), 2008a). The function of practice based learning is to provide experience, serving an important role in developing the skills of the student in interacting with patients and their families assisting in technical, psychomotor, interpersonal and communication skills (Ali and Panther, 2008). Practice based learning provides an opportunity to link theory and practice, and promotes professional identity development (Fishel and Johnson, 1981). Practice based learning is also crucial in the profession of nursing due to the vocational nature of the work, and necessity of assessing clinical competency and safeguarding the public (Rutowski, 2007). By ensuring specific standards are met with assessment in practice, it effectively ensures that students are fit for practice at point of registration (NMC, 2004). My demonstration of demonstrating my eligibility to supervise and assess students in a...
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...of method to deal with pain during childbirth. The management of labour pain is a primary responsibility of the nurse. It is important for the nurse and the labouring mother to develop mutually acceptable goals for pain relief. The nurse can best facilitate this process by conducting a thorough assessment, implement timely interventions, provide non-pharmacological methods of pain relief alongside or separate from pharmacological methods, and provide comprehensive health teaching regarding post-partum pain. Pain assessment during labour and delivery focuses on the physiological factors. The nurse must assess for maternal vital signs, degree of pain, fetal heart rate and pattern, and uterine activity before and after administration of medication (Wong, Perry, Hockenberry, Lowdermilk, & Wilson, 2006). It is important to assess which stage of labour the mother is in before administering medication particularly morphine, because if birth occurs within one to four hours of dose, newborn may experience respiratory depression; however, if dose is administered too early on, labour can be prolonged and delayed (Wong et al., 2006). These assessments are made to ensure the health risks to the fetus and the labouring woman are eliminated. Another important aspect of assessment is cultural factors specific to each patient and the instruments used to analyze the pain intensity level. Labour and delivery is perceived differently by each culture. The cultural assessment should encompass unique...
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...related to pain management continues to be a struggle at Banner Hospital, so it is important that a new pain management process becomes implemented. If nurses become better educated on pain management and how to asses it, if pain goals are discussed and written on the whiteboards, and if pain assessments are included in hourly rounding, pain would be better controlled and patient satisfaction scores would increase. Change, however, is never easy to implement. Once change begins, monitoring the implementation process is important to evaluate the effectiveness, the quality of the change, and how it will affect staffing. Communication also plays a vital role in the implementing process, as keeping everyone informed and empowered is important in order for change to be successful. The proposed solution to help implement the change would be to hold educational programs about pain management and assessments that each and every medical-surgical unit nurse would need to attend. The educational program will be held three times per week for each shift to complete. The program will be mandatory and each week a certain nursing unit will be assigned until all units/nurses have attended the educational program. The educational program for pain management and assessment will teach nurses about the pain process, how to assess it visually and through communication, and what interventions can be done to help manage it. The educational program will also teach nurses on how to use assessment tools...
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...(Villet-Langomarsino 2018). Pain management of the hospice patient is of great importance because it is one of the few things that can be done during the end stage of life when treatment of a disease is no longer desired. Pain is a common symptom in health care and should be one of the easiest to treat due to its popularity, but unfortunately it is not. Since pain is so unique to person, assessment and treatment must be custom tailored to each patient. The problem with pain management is its specificity to each person and disease plus the numerous ways to treat it. Without one specific roadmap of treating...
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...to the local hospice. For the purpose of this assignment the focus will be on pain, the importance of being pain free and what this would mean for Charles will be discussed through-out this case study. The World Health Organization (2008) say that freedom from cancer pain must be regarded as a human rights issue. Charles's pain was poorly controlled on admission so it took several hours for the nurse to assess and come to an agreement with Charles about how to manage his pain. The End of Life Care Strategy, written by the Department of Health have published the following guideline; " Ensure that pain amongst people approaching the end of life are kept to an absolute minimum with access to skilful symptom management for optimum quality of life." (Department of Health, 2008, p33). Historically, pain was seen as an emotion rather than a sensation that was experienced by the heart and not the brain (Meldrum, 2003). Pain in today’s society is seen as an unpleasant sensory and emotional experience associated with actual or potential tissue damage (International Association of the Study of Pain, 2011). Therefore, pain is not only experienced on a physical level such as intensity, location and quality but also with emotional feelings such as anxiety, frustration and depression. Pain is a multidimensional phenomenon and many health care professionals today adapt a more practical definition that states “pain is what the patient says it is and exists when the patient says it does” (Tollison...
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...Procedural Pain Management for the Early Childhood Patient: A Multidisciplinary Concept Analysis of Pain BLK, RN, BSN The University of Texas at Arlington College of Nursing In partial fulfillment of the requirements of N5327 Analysis of Theories in Nursing Xxxx, xx October 8, 2013 Procedural Pain Management for the Early Childhood Patient Children presenting to the emergency department are often subjected to painful and anxiety-producing procedures, both for diagnostic purposes and for treatment of symptoms. Historically, pediatric patients have not been afforded the same level of care as adults with regard to the management of procedural pain. Pain in the young child age group (1-7 years) has often been under-treated, resulting in increased fear of the healthcare setting and postponement of necessary immunizations and procedures by the patients and parents. Close examination of the concept of pain – specifically, procedural pain in the young child age group in the emergency department (ED) setting, is necessary for understanding how nursing practice may be improved in order to produce a more positive patient experience. A thoughtful review of current literature will provide insight into the concept of pediatric pain, permitting a detailed analysis. This analysis will assist in the formulation of theoretical and operational definitions of the concept for use in further study. Review of Literature A review of literature was conducted to compare and contrast...
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...Nicole Arango Required Uniform Assignment The Health History Project Health Assessment: NR302 February 7, 2016 1. Biographic Data Name Todd Matthew Riddick Phone 609-577-9068 Address 8264 SW 179th Terrace, Palmetto Bay, FL 33157 Birthdate February 28th, 1972 Birthplace Trenton, NJ Age 43 Gender Male Marital Status Divorced Occupation Radiology Technologist Employer Baptist Hospital of Miami Race/ethnic origin Black 2. Sources and Reliability Client arrived to appointment alone. Client claims to be woken by his own snoring on occasion. Client’s girlfriend scheduled the appointment due to annual checkup. Client claims that he is not hypertensive, but is on preventative medication due to family history. 3. Reason for Seeking Care Client claims appointment was made as an “annual checkup/follow-up.” 4. Present Health or History of Present Illness Subjective: Client claims he believes to be in good health. Participates in gym routines minimum of 4x a week. Client claims to eat relatively healthy. Objective: Client has a BMI of 24.3, otherwise, normal. 5. Past Health Client claims to have improved his health over the past 10 years. Client was hospitalized 3 years ago for left should reconstructive surgery due to a motorcycle accident. Describe general health Client claims to be a smoker for the past 25 years. Client smokes roughly 6-8 cigarettes a day...
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...Acute Pain: A Multidisciplinary Concept Analysis The concept of managing acute pain is extremely significant to nursing as pain is one of the most common problems for which patients seek out health care resources. Pain is a complex and abstract concept that encompasses sensory, emotional, psychological, social, and spiritual perceptions of pain that may occur in combination with physical pain. Pain is difficult to describe and often hard to measure; although, most healthcare providers agree that pain is subjective and is to be measured qualitatively and quantitatively as the patient perceives its intensity. Pain can affect the quality of life of the individual by impacting them physically, emotionally, and financially. Pain can also impact the family and support systems. The treatment of pain and the loss of income due to pain increases the costs for health care, the individual, and the population. Analyzing and clarifying the concept of managing acute pain can increase the healthcare provider’s knowledge of acute pain management, define the concept of managing acute pain, and expand the understanding of the concept of managing acute pain. The aim of this analysis is to clarify the defining attributes of managing acute pain, identify antecedents that influence the perception of pain and the possible consequences of acute pain. Review of Literature To increase the understanding of the concept of managing acute pain, it is important to explore the definitions of pain to gather...
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...Epidural Anesthesia Sharon Lopez Apollo College Obstetrics Professor Scherer October 8, 2009 Nurse Perspective Epidural anesthesia is a procedure utilized frequently, for pain relief, by woman enduring the labor process. There are many considerations that the nurse is responsible for prior to, during, and after the procedure is performed. Knowing what these assessments, provisions, interventions, and evaluations are will prevent harm of the patient and ensure suitable pain relief measures are successful. According to Wong, epidural is the most effective pain relief measure used for labor (Wong, Perry, Hockenberry, & Deitra Leonard Lowdermilk, 2006). Epidural by Definition Epidural anesthesia involves the process of placing a needle fed catheter into the epidural space of the spinal column in between the L4 and L5 lumbar vertebrae. The purpose of this placement during labor is to block the T10 to S5 required for pain relief of all body areas involved in labor without suppressing organ function and decreasing LOC (Wong, Perry, Hockenberry, & Deitra Leonard Lowdermilk, 2006). The quantity and type of medication used determines the inhibitory effects on motor function and activity. This is a consented procedure which requires adequate education. Assessment Upon admission to the labor and delivery unit, the nurse should be attentive to any surgical history, allergies, obstetrics history, current medications, renal function, last meal...
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...omission of names (Nursing and Midwifery Council (NMC), 2008a). The function of practice based learning is to provide experience, serving an important role in developing the skills of the student in interacting with patients and their families assisting in technical, psychomotor, interpersonal and communication skills (Ali and Panther, 2008). Practice based learning provides an opportunity to link theory and practice, and promotes professional identity development (Fishel and Johnson, 1981). Practice based learning is also crucial in the profession of nursing due to the vocational nature of the work, and necessity of assessing clinical competency and safeguarding the public (Rutowski, 2007). By ensuring specific standards are met with assessment in practice, it effectively ensures that students are fit for practice at point of registration (NMC, 2004). My demonstration of demonstrating my eligibility to supervise and assess students in a...
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...verbalized by the patientObjective: * Localized erythema and edema * (+) pruritus on the site of the incision. * (+) Facial grimace * (+)Irritability * (+) Guarding behavior * (+) Crying * (+) VS normal T= 36.8 ‘ c PR= 77 RR= 25 * Pain assessment>Location: Right post auricular area>Interval: frequent | Acute pain related to tissue trauma secondary to incision and drainage as manifested by * Localized erythema and edema * Pruritus on the site of the incision * Facial grimace * Irritability * Crying * Guarding behavior * Frequent interval of pain | Nociceptive stimuli(wound/inflammation)↓Nerve fibers (nociceptor) ↓ ↓A-delta fiber C-fiber (fast) (slow) ↓ ↓ Spinal cord & Dorsal horn pain modulating circuit (primary touch fiber) Neospino- Paleospino- thalamic thalamic tract (sharp, tract (dull,bright pain) aching pain) Substantia Gelatinosa (synapse) Thalamus (center of awareness of pain) Cerebral Cortex (center of interpretation) Responses | After 6 hours of nursing interventions, the pain will be...
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...Running head: BORETZKY FAMILY HEALTH ASSESSMENT Boretzky Family Health Assessment Michelle Phoebe Baltazar Grand Canyon University: NRS-429V September 8, 2012 Boretzky Family Health Assessment Gordon’s functional health pattern assessment is a tool that nurses can use to analyze a person’s whole being that incorporates every aspect of that person. Through this approach, nurses can ensure that holistic care is provided. The Boretzky family was therefore interviewed to analyze each functional health patterns in order for the nurse to identify two wellness nursing diagnosis that could help the family live an optimal lifestyle. Functional Health Pattern Findings The Boretzky family is a well-educated family which showed during the interview in regards to health maintenance/perception, nutritional pattern, and exercise pattern. During the interview both Staci and Barry, mentioned the correlation of healthy living with healthy diet that incorporates the recommended food pyramid and regular exercise into their daily routine. “To promote a healthy lifestyle I make sure to take a multivitamin every day, eat the recommended amount of fruits and vegetables and stay active by going to the gym every day. When possible, I also try and get a good amount of sleep every night” (S. Boretzky, personal communication, September 5, 2012). Moreover, both children also correlated the intake of foods high in fiber to maintain a regular elimination pattern. This shows...
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