...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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...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 applied in the body of the patient in the post operative care which can be very much preventive. The epidural infusion functions...
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...modalities on resolving pain and tension issues based on chronic postural imbalances. In this case study there will be assessing of the client's conditions, facilitating techniques based on the symptoms and drawing conclusions of the efficacy of the applied techniques as a protocol for the given conditions. Introduction: 1. The therapeutic concern for my client is to relieve moderate and chronic pain that stems from the neck down the shoulder blade and into the upper arm and mid-back at rest and during daily activity. With the pain and tension comes a compromised active, passive, and resisted range of motion in the actions...
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...hospital for complaints of pain in his head. The associated system with this case study is the neurological system, which is the system in the human body that deals with a network of nerves and cells that send messages from the brain and spinal cord to the rest of the body (Mandal, 2013). Based on this case study a SOAP note, which consists of a subjective data, objective data, an assessment, and a plan, will be created to help identify and assess the condition of the patient. Subjective: The patient, Mr. Chestnut, is an 89-year-old male, who was admitted into the care facility with his caregiver/family member, complaining of pain in his head. The patient states that the pain began two days ago, and has been fluctuating...
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...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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...Pain and Aggression in Nursing Home Residents With Dementia Ahn, Hyochol; Garvan, Cynthia; Lyon, Debra. July/August 2015. Pain and Aggression in Nursing Home Residents With Dementia. Nursing Research. 64(4):256-263. Primarily, pain may impact the combative behavior of residents with dementia in nursing homes. Conversely, nurses trained to diagnose the symptoms and pain cues can avert or lessen the pain with dementia residents who cannot communicate. Accordingly, nurses who identify pain can intervene with proper pain management, and reduction. Nevertheless, aggressiveness is an indicator of pain in dementia patients; this study discusses the correlation between pain and aggression, and the circumstances to which they emerge (Ahn, Garvan &...
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...Rheumatoid arthritis is a chronic, auto-immune disorder that causes irreversible damage. This type of arthritis causes stiffness, swelling, pain, and joint destruction. Because of the loss of function and deformity that results from this disease, the best treatment potions are early and aggressive. As Lewis, Dirksen, Heitkemper, and Bucher (2014) explained, “The primary goals in the management of RA are the reduction of inflammation, management of pain, maintenance of joint function, and prevention or minimization of joint deformity”. The proper use of drug therapy can treat all of these goals. Using the nursing process during drug therapy ensures safe, effective treatment. The nursing process offers a systematic approach that aids...
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...policy regarding geriatric and/or demented patients and pain control. I believe this needs to be changed because although we have an initial assessment protocol, we do not have any kind of protocol to control a geriatric or demented patients pain. Since demented patients are quite often left unable to communicate their feelings, I believe there would be, less adverse effects and better patient outcomes for this group of people and better satisfaction with their families. B There are many people associated with proposing the change within the facility. First would be to go through the assistant nurse manager and nurse manager who would then bring the proposal to the nursing and medical directors for the ER. The ANM and NM would have to decide whether the proposed change would be beneficial for the patients and their outcomes and do further research which they would then propose to the directors. From there, they would decide whether the research was sufficient enough to implement a change. C Full APA citation for at least 5 sources | Evidence Strength (1-7) and Evidence Hierarchy | 1. H., Bell, J., Karttunen, N. M., Nykänen, I. A., M., & Hartikainen, S. A. (2013). Analgesic Use and Frailty among Community-Dwelling Older People. Drugs & Aging, 30(2), 129-136. doi:10.1007/s40266-012-0046-8 | 2 and Experimental | 2. Haasum, Y., Fastbom, J., Fratiglioni, L., Kåreholt, I., & Johnell, K. (2011). Pain Treatment in Elderly Persons With and Without Dementia...
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...Chest pain is the presenting complaint of quit a few patients in general. Most of the times it represents nonlethal syndromes such as one involving muscles and gastrointestinal tract but it can be indicative of serious medical emergencies as well including heart attack and lung diseases. A differential diagnosis can be easily developed on the basis of history and examination of the patient. Questions that are help full in diagnosis are as follows: • Onset of the pain? With the help of this question GP can determine two things firstly, was patient doing anything when the pain started. Events such as stress, coughing, eating, swallowing and physical exertion can provoke specific types of pain such as pain due to acute coronary syndrome, pneumothorax,...
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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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...pyelonephritis. Those bacteria types are E. coli, Proteus, Klebsiella, or Enterobacter. If the patient experiences recurrent episodes it can lead to the kidneys being scarred and becoming dysfunctional, it will have progressed from acute to chronic pyelonephritis. (Lewis, Ruff Dirksen, Mclean Heitkemper, Bucher, & Camera, 2011, pp. 1127,1128) Assessment The patient is a 70 year old female who is a resident of a local nursing home. She has been complaining of unilateral flank pain, which she states gets more intense in the evenings. There at also been times when observed by staff at the nursing home when she seemed increasingly confused or disoriented. During the assessment she stated her flank pain was 8 out of 10, a fever was also noted at 38.9 degrees Celsius. As the assessment furthered she also stated that she has had a decrease of appetite and some GI discomfort. She stated this has been going on for about 4 days, she does require in and out catheterization which she performs herself. Nursing Diagnosis The patients nursing diagnosis is: Acute pain r/t inflammation of the urinary tract aeb patient states her pain level is a 8/10 and increases in the evenings. (Ackley, B.J. & Ladwig, G.B. 2011). Plan Complete all ordered labs and diagnostics for confirmation of diagnosis. Administer all ordered medications such as...
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...Final exam study guide: Cancer: Know the difference between Benign and Malignant tumors. Classification of tumors Benign neoplasm Well differentiated Usually encapsulated Kidneys have their own capsule so is easier to catch Expansive mode of growth Characteristics similar to parent cell Metastasis is absent. Rarely recur Classification of tumors Malignant neoplasm May range from well differentiated to undifferentiated Able to metastasize Infiltrative and expansive growth Frequent recurrence Moderate to marked vascularity Rarely encapsulated Becomes less like parent cell Check Moles and Freckles Shows differentiation Hair growing = blood supply = no differentiation = CANCER * Know the warning signs/clinical manifestations of cancer. * CAUTION: * Change in bowel or bladder habits * A sore that does not heal * Unusual bleeding or discharge from any body orifice * Thickening or a lump in the breast or elsewhere * Indigestion or difficulty in swallowing * Obvious change in a wart or mole * Nagging cough or hoarseness Know the different staging, grading and classifications of cancer. Clinical staging classifications * 0: Cancer in situ * 1: Tumor limited to tissue of origin; localized tumor growth * 2: Limited local spread * 3: Extensive local and regional spread * 4: Metastasis * 0 – enclosed extremely localzed * 1 – only in tissue...
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...Undergraduate Research Projects Title: Thesis Adviser: Author: A Predictive Model of Attention in Viewing Selected Grocery Food Products Ms. Rosemary Seva Kathleen V. Garcia Kimberly L. Go Winnie V. Grindulo Date: Call Number: Abstract: Studies on visual attention have identified certain visual factors that attract consumer attention. Visual attention had been found to be related to instore visual factors such as shelf position, number of facings, and packaging design. However, despite their importance attracting consumer attention, no studies had been found to consider combined effects of these factors in consumer attention. As such, this study considered the combined effects shelf position, number of facings and packaging design with the objective of identifying the significant factors and of developing a predictive model of attention. The significant effects of in-store visual factors specifically number of facings, horizontal and vertical shelf positioning, the color, size, and material of, and the text and image on the packaging was used in the development of a conceptual model in predicting attention as measured by the frequency of fixation and the duration of fixation. In order to validate the developed model, an eye-tracking experiment was conducted. Using an eye-tracking device that records the frequency and duration of fixation, the subjects were asked to view a life-size picture of a shelf. Multiple regression analysis was used to analyse the data gathered from the...
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...8-year-old twin boys and a husband of 7 months pregnant. Limited Upper limb (UE) movement using left and trunk support make him unable to drive or commute with ease. Meal preparation or clean up may need extra times due to difficulties in mobilization one side of the arm and reduced trunk support. Sleep and rest may be influenced from pain and immobilization. Education and work are also negatively influenced by current body condition, he might present fatigue, limited concentration. Also, pain causes him to perform work with max function. Play and leisure participation should be monitored from not to develop secondary conditions and consideration must be made with his physical condition prior to play/leisure. Social participation might be limited in environment he need to make vigorous movement or assistive device cannot be worn. COPM will be used to evaluate Xavier to understand issues related to self-care, productivity, and leisure. During the assessment, Xavier will indicate the areas where he is experiencing difficulties such as ADL s including self-care such as dressing, eating, personal hygiene, grooming and functional mobility. After the assessment, the therapist is able to see in which area client needs services...
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...Nursing Practice Situation: Recognizing drug seeking behaviors in the emergency department (ED). Since The Joint Commission aggregated pain as the fifth vital sign, it has been the motivation of many ED’s to provide swift and sufficient pain management in a timely fashion (Pentin, 2013). Pain is among the leading reasons for ED visits (Thomas, 2013). Data: Information was collected on patients complaining of or exhibiting the following drug-seeking behavior (DSB): headache, back pain, dental pain, demanding specific medication, requesting a refill on narcotic medication, reporting medications or prescriptions as being lost or stolen or having run out, reporting 10/10 pain or greater, report of breakthrough pain with requests for additional doses, and requesting medication parenterally (Grover, Elder, Close, & Curry, 2012; Weiner et al., 2013). In addition, DSB was further defined to include patients that had received four or more opioid prescriptions by at least four providers within the last year prior to presenting to an ED (Weiner et al., 2013). Information: Independently, the data collected simply represents a thorough pain assessment. However, a well-documented comprehensive record in the electronic medical record (EMR) improves communication between health care professionals and allows for proper interpretation of a patients clinical presentation. However difficult, nurses must not only feel permitted but obligated to use descriptors such as “addiction,” “substance...
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