Management of Pain Samples for Students †MyAssignmenthelp.com

Question: Discuss about the Management of Pain. Answer: Pain is a physiological, sensory and emotional experience, which is associated with actual or potential tissue damage. It is a universal experience. It is a subjective sensation, which is difficult to define. Pain has a biologically important protective function. The procedure of pain development is usually initiated by noxious stimulus and transmitted over a specialized neural network to the central nervous system, where it is interpreted. Based on the type of pain, the patients pain management plan is developed (Barr et al. 2013). In this essay, a case study of pain management has been demonstrated, while including the pain pathophysiology, all the dimensions of pain management in order to make the assessment a holistic one and the interventions related to the pain management, for particularly the student. A 45 years old patient named Mr. Alex has been admitted to the emergency ward, with severe pain and swollen left leg along with other minor cuts and injuries throughout his body; upon undergoing a fall from his bike. After performing immediate X-ray, it was found that the person had his left leg broken, as a result of fall. Upon admission, the person was screaming in pain. Thus, one of the immediate actions that thenursing professional needs to do was to manage his pain. Initially, pain assessment was done for the patient by the registered nurse. For this, the pain scale has been used. As the patient was in severe pain, the visual analog scale was used. This scale uses a scale of 1 to 10 ranges, in order to define the level of pain the patient is experiencing, by analyzing his facial expression. In this pain assessment, Mr. Alex scored 8, which is signifying that the patient is experiencing intense and horrible pain, indicating the need for immediate pain management. According the pathophysiology of pain, it is stimulated by the neurological pathway. For instance, pain sensation is the normal biological response to injury or disease, which is resulted from the normal physiological process in the nociceptive system through a complex process. The key stimuli of pain are the tissue injury or fracture. In case of Mr. Alex, the tissue injury occurred, when the bone in his left leg broke along with the injury to the surrounding soft tissue (Abdulla et al. 2013). In case of fracture, there are mainly three stages of pain. For instance, acute pain occurs immediately after the fracture of the bone; followed by the sub-acute pain, which lasts for first few weeks after the fracture, this is the period of healing bone and soft tissue. However, chronic pain continues long after the fracture and soft tissue, after completion of healing. Pain is a crucial function of immune response towards external pain stimuli, which involve CNS and nociceptors for transmitti ng messages from the stimuli to brain. Initially after the soft tissue damage surrounding the broken bone in Mr. Alexs leg, the nociceptor or the sensory receptors present in the surrounding area detects the helpful or noxious stimuli, which transmits electrical signal to the nervous system. Two types of nociceptors include the C-fibres and A-delta. Nociceptors consist of variety of voltage-gated channels to transducer signal leading to a set of action potentials to initiate the electrical signalling into the nervous system (Cousins and Lynch 2011). In pain pathophysiology, the CNS also plays important role. The electrical signal brought by the nociceptor attains the spinal cord, where a complex array of neurons in the synaptic connections processes the signal to the cerebral cortex of brain. The signal is received in numerous area of brain. As a result, the responses towards pain and emotional reactions varied so much (Fishman 2012). However, as the broken bone may also damage the nerve ending, the pathway of pain processing is altered, which has caused increased pain signal transmission, thereby enhancing the intensity of pain the person is experiencing. Therefore, in case of Mr. Alex, due to both of the tissue and nerve ending damage, the pain is severe. Alex may need to under immediate surgery to fix the bone, upon local anaesthesia. The three stages of pain will have different types of impact upon the patients life. For instance, the patient is a 45 years old male, who is employed and is responsible for his familys financial status. However, due to his injury and massive pain, he would not be able to move through the first phase, i.e. acute pain phase, which will last for 2-3 days. During this phase, he would need assistance fromnursing staffs or his family members, in order to complete his daily activities, like bathing, dressing, toileting, moving or other works. For the massive pain and independence, his self-esteem is likely to be decreased, which also introduces stress and anxiety in the patient, thereby hampering the psychological well being of the patient (Burchiel 2011). On the other hand, as the patient would not be able to go to his work, while he have to avail treatment expenses, financial constrain is a common issue, which would also impact upon his social and spiritual well being. Regarding legal as pects, the nurses and other medical staffs are liable to meet the needs of the patient in order to eliminate ethical issues. In the next phase, i.e. sub-acute phase, as the healing process is started, the pain would be significantly reduced from the first stage. However, in case of Mr. Alex, he would continue his pain medication through the phase, which will last for 2-3 weeks. At this phase, the patient would be able to complete his daily activities with little or no assistance fromnursing staffs or family member. He would also be able to improve his self esteem. However, at this phase, the patient will not able to join his work, as a result the financial constrain may occur, which would again include stress, thereby hindering his overall wellbeing. At the final stage, i.e. chronic pain, the heath process is complete, but the pain remains due to the damage to nerve endings (Abou-Setta et al. 2011). Without follow up checkups or other required medical processes or lifestyle management or proper rehabilitation, the patient may have some difficulties in future life related to his mobility or employment, whic h again can negatively affect his overall wellbeing. For instance, reduced mobility may hinder his social and cultural life, which in turn reduce his self esteem and hope for the life, reducing spiritual well being. He may also face discrimination in his organization, due to his physical inability, which would lead to an ethical as well as legal issue. As a result, stress and depression may result as psychological negative outcomes. One of the initial responsibilities of the health care team developed for Mr. Alex is to manage his pain. There are several pharmacological and non-pharmacological ways, through which the Mr. Alexs pain can be reduced. Initially after his surgery in order to fix the fractured bone, the immobilization of the bone has been done, which would restrict the mobilization of the fractured bone, which would reduce the worsening of the pain. To reduce pain and inflammation, the pain medications would be provided to Mr. Alex. However, the dosage and group of the medications would vary, according to the level of pain, as assessed in the pain scale throughout the healing process (Body et al. 2011). As Mr. Alexs pain score was as high as 8 initially, in visual analog scale, initially he would be administered with stronger pain reliever. In case of Mr. Alex, initially, as his pain was severe, strong pain medication would be provided, which includes morphin sulphate, which is usually administered, w hen the pain is moderate to severe. The medication would be administered through IV route. However, prior administering the medication, the patient needed to be assessed for any kind of allergy. Drugs used to treat fractures include nonsteroidal anti-inflammatory agents (NSAIDs) and analgesics. With progress, the patient would need mild to moderate pain reliever. In this context, as his leg has been swollen, inflammation has been taken place, as a result of tissue damage and necrosis. Thus, the patient needs to provide anti-inflammatory medication also (Duke et al. 2013). Thus, NSAIDs are suitable for Mr. Alex. These drugs have analgesic and antipyretic activities.In addition, he would be administered with tetanus vaccine, to reduce chance of infection. Besides these pharmacological treatments, there are non-pharmacological ways to reduce his pain. The initial responsibility of nurse is to make a positive relationship with the patient and continuously encouraging him to cope with the situation. Through the acute and sub-acute phase, the immobilized area of leg should be placed onto a pillow, in order to reduce pain. The position of the patient and postures of the injured leg needs to be changed frequently. In addition, the patients family members should be involved in his care plan, who will motivate and empower his healing process (Morton et al. 2017). Through progression, after releasing from the hospital, a physical exercise plan would be provided by his physiotherapist, in order to improve his leg movement and helping him to carry on his normal lifestyle. In conclusion, it can be said that pain management is a significantliability of nursing staffs, while handling a patient in acute or chronic pain. Based on the type of pain, the pain management plan is developed. For instance, both pharmacological and non-pharmacological pathways would be suitable, based on the patients condition. Pain assessment is crucial throughout the therapeutic procedure. References Abdulla, A., Adams, N., Bone, M., Elliott, A.M., Gaffin, J., Jones, D., Knaggs, R., Martin, D., Sampson, L. and Schofield, P., 2013. Guidance on the management of pain in older people.Age and ageing,42, pp.i1-57. Abou-Setta, A.M., Beaupre, L.A., Rashiq, S., Dryden, D.M., Hamm, M.P., Sadowski, C.A., Menon, M.R., Majumdar, S.R., Wilson, D.M., Karkhaneh, M. and Mousavi, S.S., 2011. Comparative effectiveness of pain management interventions for hip fracture: a systematic review.Annals of internal medicine,155(4), pp.234-245. Barr, J., Fraser, G.L., Puntillo, K., Ely, E.W., Glinas, C., Dasta, J.F., Davidson, J.E., Devlin, J.W., Kress, J.P., Joffe, A.M. and Coursin, D.B., 2013. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit.Critical care medicine,41(1), pp.263-306. Body, J.J., Bergmann, P., Boonen, S., Boutsen, Y., Bruyre, O., Devogelaer, J.P., Goemaere, S., Hollevoet, N., Kaufman, J.M., Milisen, K. and Rozenberg, S., 2011. Non-pharmacological management of osteoporosis: a consensus of the Belgian Bone Club.Osteoporosis international,22(11), pp.2769-2788. Burchiel, K.J. ed., 2011.Surgical management of pain. thieme. Cousins, M.J. and Lynch, M.E., 2011. The Declaration Montreal: access to pain management is a fundamental human right. Duke, G., Haas, B.K., Yarbrough, S. and Northam, S., 2013. Pain management knowledge and attitudes of baccalaureate nursing students and faculty.Pain Management Nursing,14(1), pp.11-19. Fishman, S.M., 2012.Bonica's management of pain. Lippincott Williams Wilkins. Morton, P.G., Fontaine, D., Hudak, C.M. and Gallo, B.M., 2017.Critical care nursing: a holistic approach. Lippincott Williams Wilkins.