Question

In: Nursing

A 79-year-old woman had a femur fracture for which she had an open reduction with internal...

A 79-year-old woman had a femur fracture for which she had an open reduction with internal fixation (ORIF) surgery 6 weeks ago. She has been going to physical therapy (PT) but finds that her pain and anxiety prevent her from following the instructions provided by PT. She continues to take her oral opioid on an as-needed basis and believes that she cannot function without it. Her physical therapist suggests that she look into nonpharmacologic methods of pain management, including improving her spiritual health. Today she is having her follow-up with the orthopedic surgeon. She asks you, the office nurse, for advice on what she should do. The surgeon wants her to discontinue the opioid medication immediately.

1. Which questions will you ask the patient at this time in preparation for teaching?

2. What are the concerns about her current pain management regimen?

3. Which nonpharmacologic methods might benefit her? How will you determine if they are appropriate for her values and beliefs?

4. Who else on the interprofessional team might be able to help this patient and how?

Solutions

Expert Solution

1. The questions I shall ask to the client are =

a) Identification data = name,age, sex, date of admission, diagnosis, date of surgary.proper History of accident has to take.

b) present complaiance of the client likes as level of pain, time of onset of pain, frequency of pain, duration of pain has to be assessed.

c) what measures he takes to reduce the pain?

d) Type of activities he has to do in daily life, any type of hard work if do.

2. She is using opoids for pain relief. Opoids are very good tranculizer. But it can cause various side effects like as nauaea, vomiting, diarrhoea, dehydration and also cause tolerance, drug dependence and adiction. So, she should not continue that medication for a long period of time.

3. The non pharmacological methods like as = I. Hot and cold application = this method relif pain by increasing blood circulation to the site of pain.

ii. Relaxation therapy= this will cause progressive muscle relaxation ans relif the pain.

iii. Trans cutaneous electrical nerve stimulation therapy = this will stimulate stimulation of the nerve endings and produce a tingling sensation and a electrical impulse gose through the spinal cord to the brain. This relaxes muscles of that area and relif pain.

iv. Proper comfortable positioning of the leg can relif the pain.

4. The psychiatric group can help the patient. As she requires a proper councelling about all her crisis setuation. She is vary anxious about her condition and pain and abusing the opoids drugs. So, to prevent anxiety and to return to her normal life and accept the physiotherapy as an effective treatment for her body to healing up and cope up with the setuation.


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