What is one thing you could do to ensure Justin Jones’ safety while managing his acute pain? List two more things you need to know about Mr. Jones to begin his discharge planning.

QUESTION

ANSWER

Providing Optimal Care to Justin Jones: Managing Acute Pain and Addressing Potential Biases

To care for a client like Justin Jones, several areas of general knowledge are essential. These include:

Knowledge of pain management: Understanding the principles and techniques of pain management is crucial when caring for a client with acute pain. This includes knowledge of different pain assessment tools, pharmacological interventions such as PCA pumps, and non-pharmacological interventions such as positioning, distraction techniques, and relaxation therapy.

Knowledge of musculoskeletal trauma: Familiarity with the different types of musculoskeletal injuries, their assessment, and interventions is important for providing appropriate care. This includes knowledge of casts, traction, and potential complications such as muscle spasms, neurovascular dysfunction, and skin breakdown.

Knowledge of diabetes management: Being aware of the specific needs of clients with Type 2 diabetes mellitus is important to ensure proper management of blood glucose levels during the hospital stay (Kalra et al., 2018). Understanding the potential impact of pain and stress on blood sugar control and the appropriate administration of insulin or other medications is crucial.

Knowledge of geriatric care: Recognizing the unique needs and challenges faced by older adults is essential when caring for an elderly client like Justin Jones. This includes knowledge of age-related changes in physiology, common comorbidities, and considerations for safe and effective care delivery.

To ensure Justin Jones’ safety while managing his acute pain, one important action would be to closely monitor his respiratory status. Opioids such as morphine sulfate, which is being administered via the PCA pump, can cause respiratory depression, especially in older adults. Regular assessment of his respiratory rate, depth, and oxygen saturation levels will help detect any signs of respiratory compromise and allow for timely intervention.

Two additional pieces of information needed for Mr. Jones’ discharge planning include:

Home environment assessment: Evaluating Justin Jones’ living situation, such as the accessibility of his home, potential safety hazards, and the availability of support from family members or community resources, will help determine his ability to manage activities of daily living and navigate his home environment after discharge.

Rehabilitation needs: Understanding the extent of Justin Jones’ musculoskeletal injuries and his overall physical condition will help determine the need for rehabilitation services post-discharge. Assessing his mobility, strength, and ability to perform daily tasks will guide decisions regarding the type and duration of rehabilitation services, such as physical or occupational therapy.

Another nursing diagnosis that might be appropriate for Justin Jones is Impaired Physical Mobility. This diagnosis addresses the limitations in his physical movement caused by the casts, traction, and overall musculoskeletal trauma. The goals and expected outcomes for this diagnosis would focus on improving mobility, preventing complications such as contractures or muscle atrophy, and facilitating independence in activities of daily living.

Rewritten goals/expected outcomes for the Acute Pain nursing diagnosis for Justin Jones on November 10:

Justin Jones will demonstrate correct use of the PCA pump by accurately utilizing the device for self-administration of analgesia with proper understanding of the medication dosage, lockout intervals, and potential side effects (Winacoo & Maykel, 2009).

Justin Jones will rate his pain not higher than 4 on a scale of 1 to 10 at all times, indicating effective pain management and relief of discomfort associated with musculoskeletal trauma and muscle spasms.

Justin Jones will exhibit peripheral pulses that are palpable, indicating adequate blood flow and neurovascular perfusion to the extremities.

Justin Jones’ fingers and toes will remain warm, indicating adequate tissue perfusion and prevention of ischemic complications.

Justin Jones’ fingers and toes will be without pallor or cyanosis, indicating adequate oxygenation and perfusion to the extremities.

Justin Jones will exhibit no edema of fingers and toes, suggesting adequate venous return and prevention of fluid accumulation.

Justin Jones’ capillary refill will be less than 3 seconds, indicating adequate peripheral perfusion and normal capillary integrity.

When providing care to Justin Jones, nurses should be aware of their own beliefs, values, biases, and emotional responses that could potentially interfere with the provision of optimal care.

Some possible factors that may influence care delivery include:

Ageism

 Unconscious biases or stereotypes towards older adults may lead to assumptions about their abilities, independence, or response to treatment. It is important to approach care without age-related prejudices and provide individualized, person-centered care to Justin Jones.

Pain management biases

 Preconceived notions about pain levels or skepticism towards clients’ self-reporting of pain can affect the assessment and treatment of acute pain. Nurses should be attentive to clients’ subjective experiences and ensure appropriate pain management interventions are provided.

Cultural considerations

Cultural beliefs, values, and practices related to health and illness can influence communication, decision-making, and adherence to treatment (Swihart, 2022). Recognizing and respecting Justin Jones’ cultural background and tailoring care accordingly will enhance his overall experience and outcomes.

Emotional responses

 Caring for clients who have experienced traumatic events like automobile accidents can evoke emotional responses in healthcare providers. Recognizing and managing these emotions effectively is crucial to maintain professionalism and provide the best possible care to Justin Jones.

By acknowledging and addressing these potential biases and emotional responses, nurses can ensure they provide unbiased, empathetic, and patient-centered care to Justin Jones, promoting his well-being and facilitating his recovery process.

References

Kalra, S., Jena, B., & Yeravdekar, R. (2018). Emotional and psychological needs of people with diabetes. Indian Journal of Endocrinology and Metabolism, 22(5), 696. https://doi.org/10.4103/ijem.ijem_579_17 

Swihart, D. L. (2022, November 14). Cultural Religious Competence in Clinical Practice. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK493216/ 

Winacoo, J. N., & Maykel, J. A. (2009). Operative Anesthesia and Pain Control. Clinics in Colon and Rectal Surgery. https://doi.org/10.1055/s-0029-1202885