Question

Choose a topic that interests you and is related to your area of study or professional field. Explain why this topic interests you and is related to your area of study or professional field. Research this topic and write an essay that incorporates information from 3 different sources. Cite your sources using APA standards learned in this unit. The paper should be at least 300-400 words in length, double-spaced, and in Times New Roman font. You should also include a word count. AREA OF STUDY IS HEALTH SCIENCE

Answer 1

PAIN MANAGEMENT IN THE INTENSIVE CARE UNIT

Being a PACU nurse one of the hardest hing i find is ensuring accurate pain management.Each patient is unique ,and their ability to tolerate pain level is also different.Pain experienced by patients in the ICU may arise from a variety of situations such as underltying medical disease,trauma or invasive procedures.Furthermore monitoring and therapeutic devices ,routine nursing care and prolonged immobility may also cause pain and discomfort in this population.

The degree of analgesia in critically ill patients is often inadequate.one of the reasons is that the level of pain is harder to assess in ICU patients because patients are often confused,unable to communicate ,or even paralyzed.Furthermore practicioners may be overly concerned about the adverse effects of pain treatment.

Efforts should be made to objectively quantify and systematically document the patients level of pain.Pain assessment and response to therapy should be performed regularly by using a scale appropriate to the patient population.

• In an awake and alert patient ,the most reliable indicator is the patients self-report .Several pain assessment tools are available.unidimensional tools are used more frequently.
• In sedated and non-interactive patients ,assessment of pain is more challenging .Physiologic indicators and the general presentation/pain-related behaviour of the patient ,as well as the change in these parameters after analgesic therapy,are used to estimate the level of pain.

The therapeutic goals is to adequately manage pain and to provide analgesia to all criticallyill patients.A desirable analgesia is considered ,for example ,a pain rating greater than or equal to 3 of 10 using the VAS scale.Besides the primary goal of optimizing patient comfort,adequate analgesia is crucial to attenuate potenially deleterious physiologic responses to pain,that is ,sympathetic activation with tachycardia and increased myocardial oxygen consumption ,persistent catabolism,hyper coaguability,and immunosuppression.Other benefits of adeqate pain relief are the prevention of thrombosis and pulmonary embolism by earlier patient mobilization.Furthermore epidural anaesthesia ,for example ,may shorten postoperative ileus and lower the morbidity of cardiovascular and pulmonary complications after thoracic and abdominal surgeries.

There are pharmacologic and non pkharmacologic options .The former works by inhibition of the release of local mediators in damaged tissue,blocking the nerve conduction ,while the latter includes proper postioning of patients,stabilization of fractures,elimination of irritating physical stimulation and a variety of therapies to promote patient comfort.

Mularski RA:Pain management in the intensive care u .Crit Care Clin 20:381-401,2004.

Bonnet F ,Marret E:Influence of anaesthetic and analgesic techniques on outcome after surgery.Br J Anaesth 95:52-58,2005.

Jacobi J,Fraser G L,Coursin DB ,et al :Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult.Crit Care Med 30 :119-141,2002.