Larry Smith has been seen for an outpatient pre-surgery workup the evening before scheduled urologic surgery. The nurse conducts a thorough history and examination related to his back pain and concurrent pain management. His anticipated hospital stay is 2 days post-surgery.
Larry is a 68-year-old man Vital signs are blood pressure 108/64 mmHg; Pulse 88 beats/min; respirations 16 breaths/min. He has a well-healed midline scar on his back from lumbar vertebrae surgery, with a shorter scar on his right iliac crest. He moves a bit slowly with some limited lumbar range of motion. He also uses a cane for ambulating any distance. He describes his pain as a constant dull ache in the lower back that increases with prolonged standing or walking. Larry also reports a feeling of “cold electricity” down both legs, with the left greater than the right, which increases with standing and walking, as well as numbness of the middle toes on his left foot. He has been using mixed opioid and nonopioid analgesics for the past 8 years and previously had used SSRI antidepressants as adjust for his pain. His current healthcare provider waned him off Vicodin about a year ago. He now takes methadone 20 mg twice a day. When the pain is not relieved, he uses Norco for breakthrough pain. His use of Norco is 1 to 2 doses per day. Constipation is an ongoing problem, requiring stool softeners and occasional laxatives.
This activity contains 3 questions:
How should Larry’s postoperative pain be managed? Is there a referral the nurse can make to facilitate effective pain management?
How could the nurse best communicate Larry’s needs to the postoperative nursing staff?
What should be included in the care plan for postoperative management of analgesic adverse effects?
Anthony Holiday is a 28-year old steelworker for a heating and cooling company. While on the job he cut his right hand with a piece of steel for an air-conditioning vent. He is admitted to the emergency department for sutures to the right middle finger and palm. The laceration will be anesthetized with lidocaine prior to suturing.
This activity contains 2 questions:
What is the action of lidocaine?
Why is lidocaine preferred over procaine?
Last Completed Projects
| topic title | academic level | Writer | delivered |
|---|