Acute Pain Post-Op And Misuse Of Pca In An Elderly With

Acute pain post-op and misuse of PCA in an elderly with hip replacement operation RELEVANCE OF CASE Pain is formally identified as a problem of global proportions by WHO and postoperative pain is one of the most common types of pain that has raised a public health concern by various societies in Australia, USA and Europe. It affects roughly 40% of surgical patients who experiencing a moderate to severe pain. It is important that graduate RNs have the knowledge and clinical skills to care for these patients as management of acute post-op pain has posed a significant challenge in surgical specialities for the past 50 years. CASE PRESENTATION – NURSING ASSESSMENT Mrs. M’s information is currently collected from handover, her history, Mrs.†¦show more content†¦Pain that is undertreated can limit her post-op mobility and ability to participate actively in rehabilitation program. Mrs. M had pain at a level 5-8 during the night which indicates a moderate to intense pain that apparently interferes her sleep and probably limits her ability to perform normal daily activities. 5. Assess the effectiveness of PCA: Assess the PCA dose whether it met her needs. Mrs. M repeated multiple attempts PCA overnight, however the medication was not delivered successfully due to her lack of knowledge of using PCA so she only received 4mg/hr. Mrs. M could have got 6mg/ml in 1 hour if she understood instructions of using a PCA. 6. Vital signs assessment: Assess as per post-op protocol or more often if unstable to assess treatment effects, identify signs of clinical deterioration in an early stage and to detect any procedural complications. Mrs. M’s RR (respiratory rate) is 22bpm which is slightly elevated and could due to her pain, SaO2 (Oxygen saturations) is 95% which is a normal figure, she has an elevated BP of 145/90 that could result from her pain, a psychological problem such as anxiety about transferring or ambulating post-op or can even due to her cardiovascular history. Her T (Temperature) is 36.8 ° and P (Pulse) is 98bpm which are normal ranges. RR and SaO2 needs to be checked precisely because her PCA Morphine can cause potentially fatal opioid-related respiratory depression. This problem can lead to a possible need for critical care