In addition, to keep a patient comfortable, pain control promotes recovery and may reduce risk of developing certain complications after surgery. Through the use of guided imagery and other pain management strategies, the patients can achieve better pain control and improved functioning and will enjoy a better quality of life (Dobson & Byrne, 2014). Also, the inability to escape from pain may create a sense of helplessness and even hopelessness, which may predispose the patient to a more chronic depression. According to Wells, Pasero, and McCarffery (2008), around the clock dosing is recommended during this early post-surgical period to prevent severe pain and control continuous pain.
There are four specific concepts that need to be addressed while caring for a patient with pain. Beneficence can be defined as preventing harm, guarding the rights of the patients by doing what is best for the patient (Bernhofer, 2011, p. 2). Most of the health care professionals entered into this profession because they want to do ‘good’ for the patient .Uncontrolled pain can lead to complications and potentiates the onset of chronic pain. Nurses need to make assessment and recognition of pain as their priority “to do good and prevent harm” to the patients. The nurse needs to act as an advocate among their team members and work towards a common goal of identifying and treating the patient’s pain. If nurses fail to do so and withholding the
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.
When helping to relieve a pain that the patient states they have, it can help them to recover more quickly, and enables them to do activities that may have been prevented while they were in pain. In the article it states, that with adequate pain management, it would in turn decrease the length of stay, lower readmission rates, earlier overall recovery, improved quality of life, and decrease the costs for the patient and within the healthcare system (Glowacki, 2015). Due to her condition worsening while in the hospital by developing pressure ulcers, this caused a longer stay for the patient which in turn, cost the hospital more money and prevented the patient from getting better to get discharged. One organization, like the American Pain Society, are helping to come up with better ways of educating healthcare professionals to assess a patient’s pain. Healthcare professionals need to be well educated with the following: recognizing patient’s perception of pain, previous experiences with pain, spiritual and religious beliefs, and sociocultural components (Glowacki, 2015). A change also needs to be implemented to improve pain assessment, and to prevent any lapse in administration of pain medication, which can in turn increase the pain or lead to uncontrolled pain. (Glowacki,
The core skill that was involved in the last clinical placement was regarding pain assessment and management. Pain was defined as an unpleasant experience from the sensory and emotional aspects that usually involved the tissue damage in the body (Fields, 2007). Pain was classified into acute or chronic. Acute pain was a direct biological response to inflammation, tissue damage, or disease. Acute pain usually lasted less than one month. Acute pain was usually accompanied by anxiety and emotional distress. Chronic pain comprised of pain that lasted longer than a month following the healing of a tissue injury. Chronic pain persisted or recurred for three months or longer. Chronic pain was either continuous or intermittent (Frey, 2005). Pain caused by tissue damage, was called as nociceptive pain, and pain caused by nerve damage, that was named as neuropathic pain. Pain that was affected by psychological factors was known as psychogenic pain. The origin of psychogenic pain was either in tissue damage or nerve damage, relevant to the factors as fear, depression, stress, or anxiety. Pain assessment was essential to be carried out as the basis to frame out pain management interventions. The main focus of pain assessment was to express pain in terms of intensity, nature, location, duration and aggravating or easing factors. These lead to an exact template to carry out pain assessment in patients with acute and chronic pain (Fink, 2000, p.236). Pain management was an interdisciplinary approach, comprised of all interventions that were applicable to ease pain and also to alleviate the cause of the pain (Schonbeck and Uretsky, 2013). The rationale in selecting the core skill , which was pain assessment and management, was due to the impor...
Educating nurses about safe pain management will help prevent under treatment of pain and the resulting harmful effects. Using the appropriate assessment tools for assessing pain in the cognitively intact adults and cognitively impaired adults is vital, otherwise pain may be underestimated or
This was a meta-analysis evaluating the outcome on the patient satisfaction survey scores, the amount of intake of medication vs PCA usage, adverse effects and the visual analog scale which is a numerical pain rating system measured characteristics of a person experiencing pain. Data collected from Cochrane Central Register for controlled trials, Medline and Embase by authors extracted data from randomized controlled trials. RCT’s are the high quality trials for defining the relationship between the cause and effect which can provide the development of effective quality evidence based practice for the best patient outcome when performing nursing interventions.
The role of autophagy poses as a highly conserved catabolic phenomena where cells undergoing stress develop a cytoplasmic crescent shaped phagophore that matures into an autophagosome. The autophagosome is involved in engulfing damaged organelles and long lived proteins in order to replenish the cellular energy content and building blocks for biosynthesis. The autophagy phenomenon always occurs to maintain the cellular homeostasis. But, under stress there is triggering of this autophagy event beyond its basal level. The most important breakthrough in our understanding of the molecular pathway of autophagy came from yeast genetic analysis where 35 Atg (Autophagy-related) genes were identified. Various types of Cellular stress sparks an autophagy initiation response by phagophore nucleation which coverges in inactication of stress sensor mTOR (mammalian target of rapamycin).The phosphatidylinositol 3-kinase (PI3K)-mTOR pathway is stimulated upon binding of growth factors (Estrogen like growth factor, EGF; Growth factor, GF) to its cognate receptors (Estrogen like growth factor receptor, EGFR; Growth factor receptor, GFR) on plasma membrane thereby phosphorylating the receptor tyrosine moieties .This results in activation of PI3K which inturn activates Akt. Next, activated Akt phosphorylates and inactivates tuberous sclerosis complex (TSC) 1/2 which finally inhibits the mTOR complex. Changes in intracellular ATP/AMP level leads to activation of energy sensor AMPK which goes onto activate TSC 1/2.Induction of genotoxic stress also leads to AMPK activation. Ultimately mTOR inhibition causes hypo-phosphorylation of Atg13, which subsequently binds to Atg1 (mammalian homolog of Ulk1) via Atg17. Consequently, Atg1 dynamically engages At...
The importance of knowing the changes in the body of children and youth is more than clear when it is known that a fifth man spends his life as a child (Kolarov, 2005). Period of growth and development is a stressful period in which should be young adapt to changes experienced and beginning to emerge from 10-12. years of age in girls, 12-14. years of age in boys, while rapid growth and emergence comes from 11-14. year to 15-21. The boys, with girls between 8-15. The years of age, provided that there is the possibility of precocious puberty and delayed puberty, during which occur earlier or later growth and development. Longer period of time emphasizes that the postural disorders in children continues to increase, as evidenced by a growing body of research showing that the percentage of school-age children and adolescents with postural disorders exceeds over 60% (Radislavljevic, Koturović and Aranđelović 1982, Jovovich, 1999). Krsmanovic and Bigović (2006) reported that 53% of respondents have violated posture, as some authors point out that more than 70% of school children has some physical disorders, and certain problems that result from lack of movement (Ristic, Markovic and purple 2002; Velitčenko , 1993). Kovac (2000) points out kyphosis, lordosis and scoliosis, the most common deformities of the spine in a child's age, and a review of the problems of early diagnosis, interdisciplinary problems of diagnosis and treatment. The assumptions are that a number of factors affecting the occurrence of postural disorders. Vasic (2008) concludes that the deformity of the spine in school children is usually caused by poor posture, sjedelačkog lifestyle, reduced physical activity, and improper seating. Also, according to body weight and b...
On April 10, 2014, I went to a concert, which was my second time to watch a classical concert. The concert hall of this one was different from Recital hall, which I attended last time. Voertman hall has around 350 seats, which is more than Recital hall, so the space is also bigger than Recital hall. All the seats are not stepped, and Voertman has sound-isolated walls which ensures audience are not bothered by outside noises and a large stage. However, it does not have speaker because this concert hall is for chamber music and small ensemble performance. All music of this concert was related with piano. On that day, there were not too much audience in the seats. Only around 15 people which contains friends of performers dressed casually watch the concert. They talked about the music that will performed that night. The light turn off suddenly, and one Korean performer who dressed professionally walk to the stage. She bowed to us, and audience applauded to her for a while, which means the concert started.