Question

Initial Post

Mrs. Pender is eager to get up and moving around. She frequently presses the call bell to ask for assistance to the bathroom and to walk in the hall. Her gait is unsteady and she winces with pain each time she gets up but is refusing pain medication. Mrs. Pender states: “I want to get better quickly so I can get home soon”. You are a little frustrated by her insistence on not taking anything for pain and her many requests to ambulate.

Later that afternoon, Mrs. Pender’s husband comes in to visit. You introduce yourself to him and tell him how his wife is progressing. Twenty minutes later, you enter the room again to see Mrs. Pender feeding her husband her lunch. When you say “Hello” to Mr. Pender, he responds “Who are you?” Mrs. Pender asks you if you think she will be ready to go home tomorrow.

• Describe your assessment of this situation.
• Using the full-spectrum nursing model, describe how you would proceed in taking care of Mrs. Pender. (Refer to p. 34-36 in the Treas, Wilkinson, Barnett, & Smith textbook).

You

Answer 1

There are Four Important Steps incharge Nurse has to follow

Critical Thinking

Mrs Pender is an elderly female who is intense pain and also has Urinary or Fecal Incontinence (Need more History on that) and is refusing pain medication either because she thinks it is addictive or she may not be educated enough to understand the concept of pain

Her Husband Mr Pender is a substitute Decision maker and as per the history he may be suffering from Alzheimers disease

Doing

Nursing staff in the above situation has already spoken to patient and insisted on delivering the pain medication

Next step would be counselling of the patient regarding the pain medication and managing her incontinence and options available

Staff should also ask about the next of the kith and kin regarding the management of the patient

Caring

Since she is an elderly lady she should be spoken to with love and attention and should not be frowned upon

She should be explained regarding the medications and use of Adult diapers

Patient Situation

Final depending on the outcome of above modalities and absence of any substitute decision maker a final call on giving pain medication should be taken after consulting treating physician and ethical guidelines of the hospital