You are a nurse working in a busy medical-surgical unit caring for a 70-year-old female patient named Mrs. Johnson. She has been admitted several times this year due to uncontrolled chronic pain related to osteoarthritis and diabetic neuropathy. Mrs. Johnson is known for being very vocal about her pain, frequently requesting additional pain medication during her stays.
During your shift report, the nurse handing over mentions that she does not believe Mrs. Johnson is truly in pain, citing her relaxed posture, lack of facial grimacing, and overall calm demeanor when not actively requesting medication. However, Mrs. Johnson rates her pain as 8/10 on the numeric scale and insists that the current pain regimen is insufficient.
Mrs. Johnsons medical history includes:
- Osteoarthritis affecting her knees and hips
- Type 2 Diabetes Mellitus with peripheral neuropathy
- Mild hypertension
- History of depression for which she occasionally takes medication
- No known cognitive impairments
Her current pain medications include:
- Scheduled acetaminophen
- PRN oxycodone, which she frequently requests but only receives in small doses due to concerns about side effects and potential dependency
During your assessment, you observe that Mrs. Johnson is alert, oriented, and able to communicate clearly. She reports that her pain worsens with movement and interferes with her ability to sleep at night. She also expresses frustration and anxiety about her pain, feeling misunderstood by healthcare providers.
The hospital environment is busy and noisy, and Mrs. Johnson often feels isolated as most visitors have stopped coming due to the frequent admissions. She admits to feeling lonely and sometimes hopeless about her chronic pain.
What You Need to Do:
1. Understand What Affects her Pain
- Think about how age, feelings, past experiences, and even how nurses respond can change her pain.
- Pain isnt just physical, its personal!
2. Learn How to Measure this patient’s Pain Correctly
- What tools or questions will help you get the real picture of how much she hurts?
- Remember: Pain is what patient says it is. (Subjective)
3. Check the Important Details About the patient’s Pain
- Where does it hurt?
- What does it feel like?
- When did it start?
- What makes it better or worse?
- How does it affect her daily life?
4. Think About How Life Situations Change Pain
- Could the hospital setting, her mood, or loneliness make her pain feel worse?
5. Know Why You Should Assess Pain Before Treating
- Giving meds without knowing her pain fully can cause problems.
- A good assessment helps you give the right care!
6. Suggest a Simple, Realistic Non-Medication Pain Relief Method
- What can you do here in the hospital besides meds? (Example: deep breathing or relaxation techniques)
Why This Matters:
Pain care is a big part of nursing, especially for older adults. When you get it right, you help your patients feel better, trust you more, and recover faster!
How to Post:
- Your first post: at least 500 words, be detailed and thoughtful.
- Your replies to classmates: at least 250 words, share your thoughts and support!
- APA Style
- Use Intext Citations
- References for both initial post and replies
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