Question

Kate, age 57 years, is experiencing severe rheumatoid arthritis in her wrists, fingers, and knees. The joints are quite inflamed, red, and swollen. She is sitting rigidly in a chair and refuses to put on a sweater, even though she is shivering, or let anyone touch her arms. She has been prescribed an analgesic and an anti-inflammatory drug, but her dose is not due for another hour. She is feeling nauseated, so she has not eaten for the past 8 hours.

Describe the use of pain tools such as the Pasero scale and others, and which is appropriate for Kate to accurately describe her pain.

Briefly discuss the category of chronic pain related to this patient’s condition.

Answer 1

Ans) The Pasero Opioid-Induced Sedation Scale, enables the nurse to determine a patient's level of sedation before and after the administration of an opioid. A POSS score of S, 1, or 2 indicates an acceptable level of sedation, whereas a score of 3 or 4 indicates over-sedation and the need for a reversal agent.

- Pain is a common experience among mechanically ventilated patients. Pain among mechanically ventilated patients is aggravated by factors such as stage of illness, invasive procedures, and surgical interventions.

- Mechanically ventilated patients experience pain during rest as well as during routine nursing interventions. Pain levels were associated with age, heart rate, and diastolic BP. The age and past surgical history should be considered as important predictive factors.

- Chronic pain is commonly defined as any pain which lasts more than 12 weeks. Whereas acute pain is the normal sensation which alerts us to an injury or illness, chronic pain is one that persists, often for months or even longer. Chronic pain can affect as many as eight of every 10 American adults.

- Chronic posttraumatic pain: pain lasting 3 months post trauma or surgery, excluding infectious or preexisting conditions. Chronic neuropathic pain: pain caused by damage to the somatosensory nervous system.