Question

Address the following:

1. Compare identified factor(s) influencing Justice’s pain perception that you and your peer(s) discussed.

2. Consider and discuss how knowing the factors that are impacting a patient's pain could impact the treatment plan and nursing care.

Factor 1:

Justice being developmentally delayed. She is 13 years old but behaves like an 8 year old. Many small children respond to pain by crying out loudly (p. 1153).

Factor 2:

Having an older sibling who has had a previous experience with sickle cell crisis and Justice witnessing it. This can cause the patient to anticipate they are going to have the same experience and cause anxiety.

Factor 3:

Due to Justice being cognitively impaired she may have a more difficult time communicating her pain. Many people who are cognitively impaired are not less sensitive to pain they just seem do not seem to interpret sensations as painful (p. 1154).

Some physiological responses that Justice is showing is the increased in her blood pressure and pulse. "Unrelieved pain leads to hypercoagulation and an increase in heart rate, blood pressure, cardiac workload, and oxygen demand" (p. 1155). Psychological responses would be her being withdrawn which came be a sign of depression as well as the wanting her mother more frequently. Another response to the pain in the crying out and the trouble sleeping. These are signs of irritability which is another sign of pain or discomfort.

Answer 1

Considering the fact that the girl named Justice is suffering from a condition of cognitive impairment after being developmentally delayed and getting involved with the sibling who had sickle cell, the treatment for that child should be very observatory and with full considerations.

Justice is also under high BP and Cardiac workload due to hypercoagulation that had lead to high pain resulting in irritability and discomfort. Due to her situation she needs to be taken under full observation. Maintaining her physical activity, healthy sleep and other relaxation techniques can help her previously. Besides medications and thorough interaction with the family should be done.

She should be provided with the Pain Management Therapy that included with providing her with the regional anaesthesia and then continuing with the surgery(if need) to treat the problem of hypercoagulation( i.e excessive blood clotting). It will help her shortening the feel of pain and thus, her crying and relaxing her brain and body.