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Daniel Watkins is a 53-year-old man who was admitted to the hospital because of severe abdominal pain. A bowel resection was done to relieve an obstruction. By his fourth postoperative day, he is ambulating and tolerating oral intake. He has been taking both injections and oral medication for pain. The following medications are currently ordered:

- Morphine, 2 to 4 mg IV every 4 hours PRN for pain
- Acetaminophen with oxycodone (Percocet), 1 or 2 capsules PO every 4 hours PRN for pain
- Acetaminophen (Tylenol), 650 mg PO every 4 hours PRN for headache and fever

Mr. Watkins is complaining of severe pain around his incision following a dressing change and removal of surgical drains. He is very anxious and upset. He is requesting pain medication. He had his last dose of morphine 6 hours ago. He took 1 capsule of Percocet 3 hours ago for mild pain after ambulating.

1. What assessment data does the nurse need to decide how to intervene at this time?

2. The nurse decides to administer morphine 2 mg IV. What assessment should be done to monitor for adverse effects of the morphine?

3. What should the nurse document in the client's medical record about the pain management?

4. Mr. Watkins complains that the drugs do not always help when he has severe pain. What is the nurse's appropriate action for this situation?

5. What measures can the nurse teach Mr. Watkins to promote more effective pain management?

6. When Mr. Watkins complains of a headache, what medication would be most appropriate for the nurse to administer and why?

Answer :

1. Mr. Watkins, post-op, skilled incision ache controlled. 2. Nurse monitored the consequences. 3. Adverse reactions are taken into consideration. 4. Acetaminophen addressed his headache. 5. The nurse-tailored interventions. 6. The nurses need to administer acetaminophen.

1. Assessment data needed for intervention:

The nurse must accumulate records about Mr. Watkins' current pain level, including its vicinity, intensity, nice, and any exacerbating or alleviating factors. It's important to assess his important signs, respiration price, and oxygen saturation.

2. Assessment for damaging consequences of morphine:

After administering morphine, the nurse should screen Mr. Watkins for ability detrimental consequences. This includes assessing his respiratory price, oxygen saturation, and degree of attention, as morphine can reason respiratory depression and sedation.

3. Documentation within the medical document:

The nurse should report the subsequent:

  1. Date and time of the pain evaluation and interventions.
  2. Patient's ache stage before and after medication management.
  3. Medications administered, doses, and routes.
  4. Any unfavorable outcomes are located and actions are taken.
  5. Patient's reaction to interventions and any adjustments in pain level.

4. Appropriate motion for inadequate ache alleviation:

The nurse needs to assess the underlying reason for insufficient ache remedy. This may also contain re-evaluating the dosage, medication kind, and frequency. Collaboration with the healthcare company is probably essential to regulate the pain control plan efficiently.

5. Teaching for powerful pain control:

The nurse can teach Mr. Watkins the following measures:

  1. Use a pain scale to communicate ache depth.
  2. Take pain medication before the ache turns excessive.
  3. Alternate ache medications, along with the usage of each oral and IV option.
  4. Use rest strategies, deep respiration, or guided imagery.
  5. Engage in distracting sports to divert attention from aches.

6. Appropriate medicine for headaches:

For Mr. Watkins' headache, the nurse should administer acetaminophen (Tylenol) as ordered. Acetaminophen is generally used for headache comfort and is much less probably to engage with the other ache medicines he's taking.

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