...Postoperative pain Postoperative pain is an unpleasant sensory and emotional discomfort associated with the tissue damage caused by the surgery. Postoperative pain management should include a precise and a systematic assessment to manage appropriately. Pain is an internal subjective experience which cannot be seen by others or detected by investigations. Therefore the postoperative pain assessment largely rely on the clients complain and should be ongoing, individualized and documented. As the etiology is clear in postoperative pain, a single dimensional pain scale, that measures the intensity of the pain, is usually used that rates the pain out of 10 through the clients self-reporting. In some cases a multi-dimensional pain scale is used...
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...complications after an accident as she had never such a relevant past history. Her case study needs a thorough analysis which can be done through answering some important questions keeping in view the case study of Ms Angie Taylor. There are some important questions and queries in this case which needs to be resolve through proper analysis of the case study of Ms Taylor by looking at the literature. There are many complications seen in the case of Ms Angie Taylor, therefore it is very much essential to address all the questions regarding the case study of Ms Angie Taylor. Epidural infusion for pain relief in the post operative care of Ms Taylor Epidural infusion of pain relief in the post operative care can be define as the supervision in the epidural space of Opioid analgesics, mixture of opioid analgesics and local anesthetics, local anesthetics and it also supervise into many Alpha-2 agonists, for example, as an add-on to epidural clonidine might be seen in future. For pain relief in the post operative care of Ms Taylor, the use of epidural infusion can be very much effective. If it is taken as the pain reliever in the post operative care then it can be very much useful to reduce the pain. After the operation, Ms Angie Taylor direly needs a pain reliever which can provide her immense relief in pain (Bollish SJ, 1985). Therefore, Epidural infusion is very much effective and functional for pain relief in the post operative care of Ms Angie Taylor. The epidural infusion is...
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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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...Title: Pain, Coping and Sleep in Children and Adolescents with Sickle Cell Disease (Quantitative?) Abstract: Purpose The study examined the relationships among pain, pain coping, and sleep, and assessed factors (age, gender, frequency, and intensity of pain) that affect pain, coping, and sleep in children with sickle cell disease ( SCD). Methods Participants (66) were 39 children ( M = 11.5 years) and 27 adolescents ( M = 15.5 years) with SCD who completed an electronic visual analog scale ( eVAS), Pain Coping Questionnaire, and Pittsburg Sleep Quality Index. Results About two-thirds of the children reported pain the previous month. No significant differences were found between pain and age, gender, pain intensity, or frequency. Most children coped with pain by seeking information, problem solving, seeking social support, and positive self-statements. There were significant negative correlations in males between worse pain severity and behavioral distraction and internalizing or catastrophizing. The majority (91.2%) had mild to severe sleep disturbances, with 18.2% requiring sleeping medication three or more times a week. There were no significant differences between sleep and age, gender, pain intensity, or frequency. Conclusion Children with SCD experience pain that affects sleep patterns and the way they cope with pain. Nurses need to concurrently assess pain, coping, and sleep and promote sleep hygiene and positive coping strategies during pain episodes. Graves, J. K....
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...Case Study hip Fracture NSG/340 Case Study Risk Factors for Hip Fracture Age, sex (women>men), osteoporosis, poor nutrition (decreased in calcium & Vitamin D), smoking, medications (such as cortisone), limited or very little physical activities or brittle bone area all risk factors. Risk Factors for Hip Fracture related to S.P. *Age/Sex (women>men), *smoking, *medication (prednisone), *limited activity. Post-surgical anticoagulation S.P. is receiving Lovenox and Coumadin as thromboprophylaxis, a common practice after surgeries. Lovenox is used to prevent clot formation and will be an injection form, while Coumadin is taken orally, interferes with the synthesis of vitamin K clotting factor. In addition, it is recommended because of increase with coagulation factor. Anticoagulation is continued for approximately 30 days. INR is measured with the use of Coumadin with a goal of 2-3. A (arthroplasty) versus O (open reduction and internal fixation) A is also known as total hip replacement. O is metal pins, screws, rods and plates are used to immobilize the fracture. A is replacement of the entire hip joint with a prosthetic (artificial) joint system. Intraoperative blood salvage a. The blood that is lost from surgery is immediately re-administered to the patient. b. The blood lost from surgery is collected into a cell saver. c. The salvaged blood must be reinfused within 6 hours of collection. Postoperative problems Dislocation of the hip, infection...
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...As with all surgical procedures, adenotonsillectomy poses a series of potential complications in children, although these are only occasional (8). There have been a series of studies which have focused on the complications resulting from adenotonsillectomy. The Helmus study carried out on children under three indicated a low complication rate, although children in this study underwent adenotonsillectomy for chronic recurrent infections rather than for airway obstruction. Whilst Richmond et al. found a higher rate of postoperative airway complication for children who underwent surgery for airway obstruction. Berkowitz and ZalZal numerically identified a 10.5% complication rate in 190 children who underwent adenotonsillectomy for airway obstruction (9). These studies also signified that the main complications associated with adenotonsillectomy in young children are analogous to airway obstruction, postoperative haemorrhage and...
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...Clin Orthop Relat Res (2010) 468:2430–2436 DOI 10.1007/s11999-009-1220-0 CLINICAL RESEARCH Natural Course of Asymptomatic Deep Venous Thrombosis in Hip Surgery without Pharmacologic Thromboprophylaxis in an Asian Population Kosuke Tsuda MD, Tomio Kawasaki MD, Nobuo Nakamura MD, Hideki Yoshikawa MD, Nobuhiko Sugano MD Received: 8 August 2009 / Accepted: 22 December 2009 / Published online: 8 January 2010 Ó The Association of Bone and Joint Surgeons1 2010 Abstract Background The clinical importance of asymptomatic deep venous thrombosis in elective hip surgery is not clearly known. Questions/purposes We determined the preoperative and postoperative incidences of asymptomatic deep venous thrombosis, identified preoperative factors associated with postoperative deep venous thrombosis or pulmonary embolism, and established its natural course in patients who underwent elective hip surgery without receiving pharmacologic thromboprophylaxis. This work was performed at Osaka University Hospital and Kyowakai Hospital. Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research. K. Tsuda, H. Yoshikawa Department...
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...A CASE STUDY ON EXPLORATORY LAPAROTOMY WITH ADHESOLIYSIS, RIGHT HEMICOLECTOMY WITH PRIMARY END-TO-END ANASTOMOSIS ________________________________ In Partial Fulfillment of the Course Requirement In Surgical Nursing ________________________________ Presented to: The Faculty of Cebu Doctors’ University College of Nursing _____________________________ Submitted by: xxxxxxxxxxxxxxxxxxxxxxx Phi 2nd generation Class 2009 30 September 2008 TABLE OF CONTENTS I. Introduction ……………………………………………………………………. 3 II. Objectives ……………………………………………………………………... 5 III. Nursing Assessment……………………………………………………………. 8 A. Personal History Patient’s Profile Family and Individual Information Level of Growth and Development Normal Development at Particular Stage The Ill Person at Particular Stage of Patient B. Diagnostic Results…………………………………………………... 16 C. Present Profile of Functional Health Patterns ……………………. 17 Health Perception / Health Management Pattern Nutritional – Metabolic Pattern Elimination Pattern Activity / Exercise Pattern Cognitive / Perceptual Pattern Rest / Sleep Pattern Self – perception Pattern Role Relationship Pattern Sexuality – Reproductive Pattern Coping – Stress Tolerance Pattern Value –...
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...Research Article Critique: Are postoperative dressings necessary? Barbara A Body Grand Canyon University Research Critique Introduction Since 2008, the Centers for Medicaid and Medicare Services (CMS) no longer pay the full cost of care if certain hospital acquired conditions (HAC) are coded as a secondary diagnosis. Surgical site infection (SSI) is classified as a HAC and considered a preventable condition. For an eligible patient with a SSI coded as a secondary diagnosis, the hospital will only be reimbursed based on the primary diagnosis. (Medicare Learning, 2012) The hospital is left to absorb the remainder of the cost for the care of this patient. Much research has been done on ways to prevent SSI. This is a review of one quantitative study related to the effects of postoperative dressings on surgical complications, including surgical site infections. Protection of Human Participants In the study “Are Postoperative Dressings Necessary?” (Borkar & Khubalkar, 2011), 123 patients were recruited and signed informed consent. The researchers demonstrated protection of the participants from harm by way of the selection criteria. Only patients undergoing clean or clean-contaminated surgical procedures were included. Those with co-morbidity factors like diabetes or jaundice were excluded from the study, as well as those with contaminated wounds such as ruptured appendix or peritonitis. No particular benefit or risks to the participants were clearly identified by the...
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...these patients, and it usually has to be done in a short period of time. The patient can be overwhelmed with all the information they are given, the lifestyle changes that might need to be made, and the uncertainty of their future. The resulting depression that occurs, can lead to further complications and other cardiac events. Symptoms of anxiety and depression are common in patients with heart disease and these symptoms can be over-lapping. Depression and anxiety share some of the same negative affect symptoms which means that the patient has an underlying tendency to experience distress,worry, pessimism, restlessness and irritability. Anxiety symptoms can be seen as trembling, shakiness, headache, flushing, dry mouth, nausea, and chest pain (Viars, p. 283). Depression symptoms can be described as hopelessness, crying, loss of interest...
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...Pain Concept Analysis Audrey Hubler Chamberlain college of Nursing NR501: Theoretical Basis for Advanced Nursing Practice Conceptual analysis is integral in understanding nursing theory. According to Walker and Avant (1995), concept analysis allows nursing scholars to examine the attributes or characteristics of a concept. It can be used to evaluate a nursing theory and allows for examination of concepts for relevance and fit within the theory. The phenomena of pain will be discussed in this paper and how it relates to the comfort theory. This paper will define the term pain and how it pertains to the comfort theory. Next, there will be discussion from relevant literature in regards to pain. Its defining attributes will be covered and then antecedents and consequences will be addressed. Examples of empirical referents will be given, as well as a model case and alternative cases. Then the discussion will conclude with a summary of the analysis findings. Definition/Explanation of Pain According to Merriam-Webster, pain is defined as “the physical feeling caused by disease, injury, or something that hurts the body; or mental, emotional suffering, or sadness caused by some emotional or mental problem.” In general, pain refers to an unpleasant, distressful and uncomfortable feeling. Studies have shown that unrelieved pain can affect the quality of life of the individual, cause physical and emotional effects, and can impact family. The comfort theory was developed...
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...Rotator Cuff Repair PATHOPHYSIOLOGY Wells K (2013) defined rotator cuff injury as a condition involving damage to the rotator cuff tendons because of continuous irritation and tear. There are two factors that can predispose a person to this type of injury. The first type is intrinsic factor which means coming from within, this includes poor blood supply to an organ, normal attrition or degeneration with ageing and calcification of tendons. The other factor is called extrinsic factor which means coming from the outside. Some of the factors considered extrinsic are injury from accidents, falls and too much stress on the shoulders as a result of different movements involving exertion (Bilal, 2013). The injury is frequently associated with athletes who move their arms above the head in a repetitive manner like pitching, swimming, tennis and weight lifting (Wells, 2013). Paul’s occupation which is carpentry work and the repeated pitching and lifting of the ball during the rugby game eventually contributed to the irritation of his tendons from excessive pressure on the acromion process or bony knob of the shoulder. This also resulted to the swelling of bursa which is the lubricating sac between the tendons and the bones from subsequent rubbing against the acromion. Consequently, the shoulder becomes painful and if left untreated can lead to a tear in the rotator cuff and eventual injury to the shoulders (NMA News Direct, 2011). Predisposing Factors: Carpentry (repetitive...
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...Pain Assessment and Management G u i d e l i n e f o r Marlene Walden, PhD RNC NNP CCNS Sharyn Gibbins, PhD RN NNP P r a c t i c e , 2 n d E d i t i o n Pain Assessment and Management Guideline for Practice, 2nd Edition This guideline is an outline of the pain assessment and management practices that currently are accepted and documented by experts in the field of neonatal care. In addition, it summarizes and recommends pain assessment and management practices based on the best evidence for the nursing care of infants. This guideline does not preclude the use of manufacturers’ recommendations or other acceptable methods of assessing and managing pain in infants. The use of other practices known to improve the quality of neonatal care is encouraged and not restricted by this document. The National Association of Neonatal Nurses (NANN) developed this guideline in response to members’ requests. Broad in scope, it can provide a foundation for specific nursing protocols, policies, and procedures developed by individual institutions. Authors Marlene Walden, PhD RNC NNP CCNS Sharyn Gibbins, PhD RN NNP Reviewers Daniel Batton, MD, American Academy of Pediatrics Sandra Sundquist Beauman, MSN RNC Jim Couto, MA, American Academy of Pediatrics Mary Ann Gibbons, BSN RN Melinda Porter, RNC CNS NNP Ann Stark, MD FAAP, Chair of AAP Committee on Fetus and Newborn Carol Wallman, RNC NNP MS, NANN/AWHONN Liaison to AAP Committee on Fetus and...
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...the Dutch from Tidore and Ternate buying rice, beeswax and tobacco from the Spanish colony The study aimed to know xxx Statement of the problem This study aimed to look Specifically, the study answered to the following questions: 1. What is the level of attainment of xxxxxxxxxxxxxxxxxxxx 2. What is the level of effectives/impact of the implementation ofxxxxxxxxxxxxxxxxx? Is there a significant difference between the perception of the xxxxxxx and the xxxxxx? Hypotheses 1. There is no significant difference between the perception of the xxxxx and xxxxxx on the level of attainment of xxxxxx. 2. There is no significant difference between the perception of the xxxxx and xxxxx on the level of effectiveness/impact of the implementation of Republic Act . Scope and limitation of the study The analysis of this study was focus on the impact xxxxxxxxxx. The researcher chosen this area of concern because Virginia. The study was focus on xxxxxxxxxxxxxxxxxx. Significance of the Study The tobacco industry benefits the effectiveness implementation of the RA 7171 and has the economic and social impxxxxxxxxxx Through this study, Implementers will be more informed and aware of the provision of the law. If the provision of the law be amended, for the concern of the policy enhancement and eventually to development of the tobacco industry of the province. This study will be an instrument in reviewing the impact of implementation of RA 7171 and...
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...Preoperative anxiety in children is very common. Many children would experience high levels of stress, fear and worry before going into a surgery and sometimes postoperatively. From recent studies it is said that up to more than half of children who are having some sort of surgery undergo extreme cases of nervousness, doubt and panic. This occurring prior to surgery may result in unhealthy and unpleasant attitude. (Fincher W, Shaw J & Ramelet A.S., 2011) As most patients would fear hospital situations that cause pain, it is the children’s area that would more common to experience such fear and worry, especially in preoperative cases. Children also experience having distressing attitudes and find that they feel discomfort and hurt postoperatively....
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