Question

Pain Case Study Answer the following questions based on this case study

RJ is a 79 year old man who fell when he got out of bed to go to the bathroom at home. He arrived to the unit with Buck’s traction to his R lower leg, and now has had surgery for a right hip fracture two days ago. He lives alone since his wife died, and his children say he is active, but becoming a bit forgetful. They also say he is very proud and does not like to look weak or ask for help. He does admit that his R hip is a bit uncomfortable, but he’d like to wait for pain medication. The nurse comes to assess him and notes that he is restless in the bed and grimacing as he tries to adjust his position in bed. His vital signs are T 98.8, HR is 99, RR is 26, and BP Is 168/100, which is an increase compared to his baseline vital signs. He is not hungry and picked at his lunch and refused to order dinner.

His physician prescribed:

• Morphine IV every 4 hours as needed for severe pain

• Hydrocodone and acetaminophen every 4 hours as needed for moderate pain •

Acetaminophen every 6 hours as needed for mild pain.

RJ insists that the acetaminophen is all he needs and the nurse gives him the acetaminophen for pain that he reports as “just a little pain.” Upon reassessment, the vital signs and observations are unchanged and RJ is resistant to the nurse’s offer to help him get repositioned and refuses to get out of bed with physical therapy.

• What are the priority assessments with this patient?

• What is the significance of the patient’s behavior and change in vital signs?

• What should the nurse teach this patient about the benefits of using the pain medication ordered?

• Identify at least 3 different non-pharmacologic measures the nurse could use to reduce the patient’s pain in addition to the use of pain medication.

Please be sure to include APA formatted resources/citations. The answers do not have to be written in APA formatting (running head, etc)

Answer 1

1. The priority assessments with this patient are :-

- vital signs

- pain level

- mental ability

- emotional ability

2. The significance is that the patient due to his pride does not want express that he is in pain and wants to show that he can manage it himself with mild medicines. But actually he is in severe pain and refuses to change position .

3. The nurse should teach the patient that the medications prescribed by the physician are for reliving pain and it would help him to get relief of painand will make him comfortable . Also it will ease him to do his daily activities .

4. Three non - pharmacological methods to manage pain are:-

- deep breathing

- guided imagery

- music therapy