Initial Discussion Post
Week one
NURS6521, N-17 As a post-anesthesia care unit (PACU) Registered Nurse (RN), I care for patients of all races, ages, gender and ethnic backgrounds. However, a majority of the people I care for are of advanced age. Therefore, one must be aware of changes in the body related to aging. The purpose of this discussion is to present a case that addresses the considerations and issues of the perioperative care of an elderly patient.
Case Description Due to the changes in the body related to aging, pain control in older patients is somewhat difficult. The case I chose is one of a 78-year-old male undergoing femoral popliteal bypass surgery. M.M. is a 78-year-old non-smoker with hypertension, hyperlipidemia, and peripheral artery disease. As a PACU nurse, one can work with the entire perioperative team in the decision-making process concerning all aspects
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Pharmacokinetic relates to how the body absorbs, distributes, and eliminates medications. Also referred to as what the body does to the drug. Some of the changes are decreased blood flow, decreased albumin, lean body mass, and total body water, liver blood flow and mass, enzymatic activity, glomerular filtration, and secretion. Also, aging increases gastric PH, body fat, and delays gastric emptying (Arcangelo & Peterson, 2013, pp. 66-67). Changes in the peripheral nervous system (PNS) and central nervous system (CNS) include peripheral nerve deterioration, mild motor and discriminatory sensory changes in the feet, changes in the senses, and memory deterioration. An increase in the sympathetic nervous systems (SNS) causes organ-specific changes that target the gastrointestinal system and skeletal muscles affecting responses to stress and pain (Halaszynski, T., 2013). According to Hilmer, McLachlan, & LeCouteur (2007), there is an increase in adverse drug reactions, which are more severe in the
Hinkle, J., Cheever, K., & , (2012). Textbook of medical-surgical nursing. (13 ed., pp. 586-588). Philadelphia: Wolters Kluwer Health
A registered nurse (RN) is someone that went through a university or college and studied nursing; and then passed the national licensing exam to obtain a license to practice nursing. The degree earned by an RN at the need of the program is deemed a professional nursing degree. The RN top nursing staff and they usually works independently. On the hand, an LPN only earns a practical nursing degree after completion of the program. LPNs are mostly recognized only in USA and Canada; they are also named as License Vocational Nurse (LVN) in the state of California and Texas. LPN work under the supervisor of an RN or a physician.
Pain Management Nursing, 10(2), 76-84.
The nurse is creating a four-column plan of care for a client. For which areas should the nurse prepare to document when creating this care plan?
The modern nurse has much to be thankful for because of some of the early pioneers of nursing, such as Florence Nightingale and Jensey Snow. However, the scope and influence of professional nursing, as well as the individual nurse, has seen more exponential growth and change in North America since the establishment of the first professional organization for nursing, the Nurses Associated Alumnae of the United States and Canada, which in 1911 came to be known as the American Nurses Association.
“We can’t turn away from a patient’s pain just because it’s difficult” (chapman, 2015, p. 88). I know the path of least resistance is taking a path of ignorance. Easy, is to ignore or neglect the true pain patients experience in times of crisis. As caregivers I believe we all want to heal others or we wouldn’t be in the field of nursing, but there are only handfuls willing to be present during the healing process because sharing one’s pain hurts. As a surgical nurse, I find being genuinely present takes hard work on my behalf, not only mentally but emotionally. On a unit where patient’s needs and conditions are changing at astonishing rates, being present requires mental strength in order slow down enough to recognize the value presence
Volles, D. F. (2011, April 11). University of Virginia Health System Adult and Geriatric Sedation/Analgesia for Diagnostic and Therapeutic Procedures. Retrieved May 12, 2011, from University of Virgina Health System: University of Virginia Health System Adult and Geriatric Sedation/Analgesia for Diagnostic and Therapeutic Procedures
Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2010). Brunner & Suddarth’s textbook of medical-surgical nursing (12th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
American Association of Nurse Anesthetists. Professional Aspects of Nurse Anesthesia Practice. Philadelphia: F. A. Davis Company, 1994. Print.
The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety issues surrounding PCA use include infusion pump programing errors, basal infusion dosing, and proxy errors when using PCA by proxy (Ladak, Chan, Easty, & Chagpar, 2007). Therefore, the purpose of this report is to examine the benefits and risks of patient-controlled analgesia and how it relates to nursing practice.
1. What is the difference between a. and a. Which K, S, and A pertain to the care you provided to the patient you have chosen? Why do you need to be a member? K- Describe the limits and boundaries of therapeutic patient-centered care. S- Assess levels of physical and emotional comfort.
Stomberg, M., Sjöström, B., & Haljamäe, H. (2003). The Role of the Nurse Anesthetist in the Planning of Postoperative Pain Management. AANA Journal, 71(3), 197.
Kick, Ella. "Overview: Health Care and the Aging Population: What Are Today's Challenges?" The Online Journal of Issues in Nursing. N.p., n.d. Web.
Westhead, C. (2007). Perioperative Nursing Management of the Elderly Patient. Canadian Operating Room Nursing Journal, 25(3), 34-41. Retrieved from http://gateway.library.qut.edu.au/login?url=http://search.proquest.com.ezp01.library.qut.edu.au/docview/274594603?accountid=13380.
In many post- operative wards, the nurse is the frontline in helping the patient address needs for pain control. Pain