Chronic Pain Case Study
NURSING CARE PLAN: Teaching
Pt history: Pt is a 76 year old female with a history of two CVA’s (most current CVA in the L middle cerebral artery), Atrial fibrillation with mitral valve replacement, total knee replacement, hip replacement, cholecystectomy, hysterectomy, appendectomy, hemorrhoids, arthritis, gout
NURSING DIAGNOSIS: Ineffective Self Health management r/t lack of knowledge of chronic pain management aeb. patient relates consistent pain at a 5-9 on a scale of 0-10 ten being worst, statement of having “a lot of pain most of the time”, inability to relate pain management alternatives to medications that work “part of the time”, states that pain “gets in the way” of daily functioning two to three times a week on a regular basis
CLIENT …show more content…
Assess effectiveness and side effects of pain medication adjusting within doctor’s orders as needed for optimum effectiveness. Administer 1/2 dose of narcotic pain medication at least one hour prior to therapy. (Half dose indicated to prior assessment of increased drowsiness and per pt. request.)
RATIONALE
1. Many elderly or terminal patients may view themselves as dependent on their caregiver, and therefore not want to be part of the educational process.
Gulanick, M., & Myers, J. L. (2014). Nursing care plans: Diagnoses, interventions, and outcomes. (p.116) St. Louis: Elsevier/Mosby.
2. Some persons may prefer written over visual materials, or they may prefer group versus individual instruction. Matching the learner 's preferred style with the educational method will facilitate success in mastery of knowledge.
Gulanick, M., & Myers, J. L. (2014). Nursing care plans: Diagnoses, interventions, and outcomes. (p.117) St. Louis: Elsevier/Mosby.
3. Adults bring many life experiences to each learning session. Adults learn best when teaching builds on previous knowledge or experience. Addressing misconceptions from previous learning gives a starting point for current information …show more content…
Cognitive impairments need to be identified so an appropriate teaching plan can be designed. For example, the Mini-Mental Status Test can be used to identify memory problems that would interfere with learning. Physical limitations such as impaired hearing or vision, or poor hand coordination can likewise compromise learning and must be considered when designing the educational approach. Patients with decreased lens accommodation may require bolder, larger fonts or magnifying mirrors for written material.
Gulanick, M., & Myers, J. L. (2014). Nursing care plans: Diagnoses, interventions, and outcomes. (p.116) St. Louis: Elsevier/Mosby.
5. Different people take in information in different ways. Match the learning style with the educational approach.
Gulanick, M., & Myers, J. L. (2014). Nursing care plans: Diagnoses, interventions, and outcomes. (p.116) St. Louis: Elsevier/Mosby.
6. Some patients will feel uncomfortable exploring alternative methods of pain relief. However, patients need to be informed that there are multiple ways to manage pain, and few persons need to suffer unnecessarily.
Gulanick, M., & Myers, J. L. (2014). Nursing care plans: Diagnoses, interventions, and outcomes. (p.116) St. Louis:
Pt history: Pt is a 76 year old female with a history of two CVA’s (most current CVA in the L middle cerebral artery), Atrial fibrillation with mitral valve replacement, total knee replacement, hip replacement, cholecystectomy, hysterectomy, appendectomy, hemorrhoids, arthritis, gout
NURSING DIAGNOSIS: Ineffective Self Health management r/t lack of knowledge of chronic pain management aeb. patient relates consistent pain at a 5-9 on a scale of 0-10 ten being worst, statement of having “a lot of pain most of the time”, inability to relate pain management alternatives to medications that work “part of the time”, states that pain “gets in the way” of daily functioning two to three times a week on a regular basis
CLIENT …show more content…
Assess effectiveness and side effects of pain medication adjusting within doctor’s orders as needed for optimum effectiveness. Administer 1/2 dose of narcotic pain medication at least one hour prior to therapy. (Half dose indicated to prior assessment of increased drowsiness and per pt. request.)
RATIONALE
1. Many elderly or terminal patients may view themselves as dependent on their caregiver, and therefore not want to be part of the educational process.
Gulanick, M., & Myers, J. L. (2014). Nursing care plans: Diagnoses, interventions, and outcomes. (p.116) St. Louis: Elsevier/Mosby.
2. Some persons may prefer written over visual materials, or they may prefer group versus individual instruction. Matching the learner 's preferred style with the educational method will facilitate success in mastery of knowledge.
Gulanick, M., & Myers, J. L. (2014). Nursing care plans: Diagnoses, interventions, and outcomes. (p.117) St. Louis: Elsevier/Mosby.
3. Adults bring many life experiences to each learning session. Adults learn best when teaching builds on previous knowledge or experience. Addressing misconceptions from previous learning gives a starting point for current information …show more content…
Cognitive impairments need to be identified so an appropriate teaching plan can be designed. For example, the Mini-Mental Status Test can be used to identify memory problems that would interfere with learning. Physical limitations such as impaired hearing or vision, or poor hand coordination can likewise compromise learning and must be considered when designing the educational approach. Patients with decreased lens accommodation may require bolder, larger fonts or magnifying mirrors for written material.
Gulanick, M., & Myers, J. L. (2014). Nursing care plans: Diagnoses, interventions, and outcomes. (p.116) St. Louis: Elsevier/Mosby.
5. Different people take in information in different ways. Match the learning style with the educational approach.
Gulanick, M., & Myers, J. L. (2014). Nursing care plans: Diagnoses, interventions, and outcomes. (p.116) St. Louis: Elsevier/Mosby.
6. Some patients will feel uncomfortable exploring alternative methods of pain relief. However, patients need to be informed that there are multiple ways to manage pain, and few persons need to suffer unnecessarily.
Gulanick, M., & Myers, J. L. (2014). Nursing care plans: Diagnoses, interventions, and outcomes. (p.116) St. Louis: