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NUR 643 If the pain is unrelated to the admission diagnosis, what steps are necessary to take in providing a proper assessment?
NUR 643 If the pain is unrelated to the admission diagnosis, what steps are necessary to take in providing a proper assessment
NUR 643 Week 7 DQs
Week 7 DQ 2 A patient calls out on the call system and requests pain medication. We know that a patient is to rate their pain on a scale. If the pain is unrelated to the admission diagnosis, what steps will you take in providing a proper assessment?.
Importance of Controlling Pain
Inadequately managed pain can lead to adverse physical and psychological patient outcomes for individual patients and their families. Continuous, unrelieved pain activates the pituitary-adrenal axis, which can suppress the immune system and result in postsurgical infection and poor wound healing. Sympathetic activation can have negative effects on the cardiovascular, gastrointestinal, and renal systems, predisposing patients to adverse events such as cardiac ischemia and ileus. Of particular importance to nursing care, unrelieved pain reduces patient mobility, resulting in complications such as deep vein thrombosis, pulmonary embolus, and pneumonia. Postsurgical complications related to inadequate pain management negatively affect the patient’s welfare and the hospital performance because of extended lengths of stay and readmissions, both of which increase the cost of care.
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Continuous, unrelieved pain also affects the psychological state of the patient and family members. Common psychological responses to pain include anxiety and depression. 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. Patients who have experienced inadequate pain management may be reluctant to seek medical care for other health problems. (For more detail, go to the section, “Harmful Effects of Unrelieved Pain,” below.)
Poorly managing pain may put clinicians at risk for legal action. Current standards for pain management, such as the national standards outlined by the Joint Commission (formerly known as the Joint Commission on Accreditation of Healthcare Organizations, JCAHO),5 require that pain is promptly addressed and managed. Having standards of care in place increases the risk of legal action against clinicians and institutions for poor pain management,6 and there are instances of law suits filed for poor pain management by physicians.7 Nurses, as part of the collaborative team responsible for managing pain during hospitalization, also may be liable for legal action.
Hospitals stand to lose reputation as well as profit if pain is poorly managed. Patient satisfaction with care is strongly tied to their experiences with pain during hospitalization. Evidence indicates that higher levels of pain and depression are linked to poor satisfaction with care in ambulatory settings.8 With the advent of transparent health care, report cards for hospitals are becoming more prevalent, and performance on pain management is likely to be one of the indicators reported.