Which groups of patients are most at risk for inadequate pain management?

Fundamentals of Nursing ( Think Like A Nurse)

1. Think Like a Nurse: 1 Page You have checked the medication record (MAR) for Margaret Marks (Meet Your Patients, in Volume 1) and prepared her next dose of antibiotic for IV administration. The MAR also indicates that she is receiving morphine for pain and that her last dose was given 1 hr ago. When you enter the room, you find her apparently sleeping. You are not able to awaken her to verify her identity. What do you suspect is happening, and how should you respond?

2.Think Like a Nurse: 1 Page How does your diet compare to the USDA Choose MyPlate in terms of: Servings of bread, cereal, rice, and pasta Servings of vegetables Servings of fruits Servings of milk, yogurt, and cheese Servings of meat, poultry, fish, dry beans, eggs, and nuts Servings of fats, oil, and sweets

3.Think Like a Nurse: Half a Page You are caring for a patient who had an indwelling catheter removed 12 hr ago. The patient has not voided. What action should you take?

4. Think Like a Nurse: 1 Page What data do you have about Mrs. Zeno’s (Meet Your Patient) bowel function? What else would you like to know about her bowel function (What other symptoms often accompany these cues?) Which NANDA-I nursing diagnosis best describes this cue cluster? In addition to this nursing diagnosis, what other data in the scenario might be contributing to her infrequent BMs? From the scenario data, how would you describe the etiology of Mrs. Zeno’s problem? What questions do you still have about the etiology?

5. Think Like a Nurse: 1 Page Joshua is a 28-year-old patient in the intensive care unit (ICU). He had a car accident 3 weeks ago and has had several surgeries to repair a fractured femur, ruptured spleen, and intracranial bleeding. He was ventilated mechanically for 10 days and has had numerous invasive procedures. The nurses report that he is very confused and has been hallucinating.Richard is a 90-year-old man who has been a resident at a skilled nursing facility for 10 yr. He has no visitors, never leaves his room, has no television or radio in the room, and no longer speaks. He does not respond to verbal or tactile stimulation. He lies in bed in a fetal position. When staff try to move him, he moans and howls.

6. Think Like a Nurse: 1 Page Which groups of patients are most at risk for inadequate pain management?What can you do to assist each group?How do past pain experiences affect present pain experience? 7. Think Like a Nurse: Half a Page Review the scenario of Meet Your Patient in the textbook. How would you address your patient’s concerns about the risks associated with her engaging in an exercise program? Your patient has experienced a number of injuries as a result of his exercise. Based on your knowledge of physical activity, what questions would you like to ask about his exercise program?

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