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Nursing  Care  Plan  for  Pain  Management

Nursing Care Plan for Pain Management

Pain is an unpleasant physical sensation that occurs due to injury and illness. The unpleasant sensation is subjective because it depends on the intensity that a patient feels.

A nurse who is caring for a patient who is in pain should know how to access the type and intensity of pain for appropriate management of the discomfort. Pain is in two types that a nurse can distinguish according to the cause, duration, and onset.

Acute pain: The onset is slow or sudden with the intensity ranging between mid and severe. It might happen to occur after surgery, medical procedure, critical illness or trauma. The duration of acute pain is less than six months.

Chronic pain: This type of pain lasts for more than 6 months with an intensity range of mild to extremely incapacitating. Chronic pain can in some instances restrict a patient from performing daily activities and usually leads to despair.

Nursing Care Plan for Pain Management Diagnosis

As we noted, pain is highly subjective, but the description by patients about the pain they are experiencing is the best indicator. A nurse cannot prove or disprove what a patient is feeling but also cannot assume. It is also essential for a nurse to ask about the cause of pain and the period that it has been in place.

A nurse should also observe nonverbal indicators of pain such as moaning, facial grimace, crying and guarding. Nursing Care Plan for Pain Management Goals and Outcome The goals and expected the results for nursing care plan for pain management are:

  • Patient displays improved well-being such as BP, pulse, respiration, body posture or muscle tone.
  • A patient describes a satisfactory pain control at the level that is less than 3-4 on a scale of 0-10.
  • A patient uses both pharmacological and non-pharmacological pain relied strategies
  • Patient displays improvement in mood and coping with the pain.

Nursing Care Plan for Pain Management Assessment

Assessment of pain that a patient is experiencing is the first step to addressing the problem and planning strategies to manage it. A patient is the most reliable source of information regarding the ache.

Descriptive scales such as visual analogue can also enable a nurse to distinguish the degree of pain. A clearer picture about pain develops after an assessment of pain characteristics in these terms.

  • Quality for example burning, shooting and sharpness
  • Severity on a scale of 0 for no pain to 10 that indicates the most severe
  • Onset (sudden or gradual) Location regarding anatomy
  • Duration -The period of existence and whether the pain is intermittent or continuous
  • Precipitating or relieving factors

Some people deny the existence of pain, and a nurse should give attention to associated signs that might help in evaluating pain. For instance, a high heart rate, blood pressure and temperature can be present in patients with acute pain. A patient's skin can feel cold to touch and appear pale. Some manifestations that help to indicate the presence of pain are restlessness and an inability to concentrate.

Nursing Care Plan Interventions and Rationales

Assessment is a crucial step in the management of pain because it helps to determine the type, intensity, and effective relief. Nursing care plans for pain management should start by fast acknowledgment of pain reports. Early intervention can help to decrease the amount of analgesic necessary to treat a patient.

It is essential for a nurse to obtain a medical history to check current and past use of analgesic/narcotic to determine the appropriate method of pain relief. Patients with acute pain are likely to require nonopioid analgesic round the clock unless there is a contradiction.

Doctors are likely to prescribe the right medication, but nurses have a responsibility to ensure they adhere to medication instructions and administer the nonpharmacological pain relief methods such as music therapy, breathing, and relaxation exercises. These methods work by increasing a release by endorphins that help to boost the therapeutic effects of the pain relief medications.

Links  Between  Nurse  Burnout  and  Patient  Infection  Rates

Links Between Nurse Burnout and Patient Infection Rates

Nurse burnout is a mental, physical and emotional state that occurs because of chronic overwork. It might also occur due to continued lack of support and fulfillment with a job. Nursing working environment exposes the professionals to many stressful issues that might lead to burnout. Everyone in nursing can get burnout although there are those who are more risk due to their personality and working environment. It is a condition that affects the mental and emotional wellness to the point of changing the quality of life. Such a person is not in the appropriate state to offer quality care to patients.

Patient infection rates increase due to nurse burnout because they will be getting care from someone who does not have complete capability to offer the kind of care that a professional should provide.

Whats the link between Nurse Burnout and Patient Infection Rates

Overwhelming Nurse Burnout symptoms

Burnout causes exhaustion, low sense of accomplishment and job-related cynicism. It might even develop to clinical depression if untreated because unaddressed problems accumulate over time.

These burnout symptoms make it curtail that ability of nurses to interact well with patients, notice the risk of infection or offer standard care that helps patients to heal as well as preventing infections.

1.Irritability

Irritability is a frequent human emotion and is a sign of burnout when excessive or chronic. Irritability occurs because a nurse is frustrated by the work and might reduce the input at work to the extent of negligence that exposes patients to a risk of infection.

2.Reluctance and intolerance

Burnout can make nurses to feel reluctant about doing some things and intolerant to changes that help to prevent patient infections. Reluctance to work also interferes with professional efficacy meaning that the nurse offers a raw deal to patient care.

3.Calling in sick frequently

Nurses with severe burnout and are unaware of self-care methods are likely to feel sick and take more off days to recover. Nurses who suffer burnout because of staffing shortage will hurt the nurse to patient ration when the call in sick. It will reduce the number of nurses attending to patients. The nurses at work might not be able to provide adequate attention to the patient and can miss things that might cause patient infection.

4.Exhaustion and fatigue

Nurses work for long busy hours, and it is not unusual for professionals to get some fatigue. Constant exhaustion even during the off days is dangerous and is a sign of burnout. Fatigue can be emotional and physical, but both make it difficult for nurses to do their challenging jobs. Exhaustion can cause an inability to focus, confusion and difficulty in making decisions leading to these mistakes that increase the risk of patient infection.

  • Failing to ask for assistance when it is necessary
  • Medication errors by giving the wrong medicine or dosage. Some of the of the nurses are not in the right mental frame due to severe burnout and make a mistake of giving medication to a wrong patient.
  • Failing to communicate critical information that could have assisted in preventing infection or eliminating risks to their peers or physicians.Failing to contact doctors quick enough in an emergency
  • Making charting errors

Nurses with burnout are likely to have impaired memory, attention and functionality that decrease attention to the detail. Nurses with burnout are at more risk of making errors due to diminished cognitive function, vigilance and an increase of safety lapses. Such mistakes place patient at more risk of infection as the nurse is not in the right state to enhance preventive measures.

Burned out nurses are detached from work and unknowingly develop negative attitudes towards the patients. All the factors that are causing fatigue impair the capacity to deal with technically complex and dynamic nature of efficient nursing care.

Nurse fatigue that leads to burnout is dangerous to nurses and even their patients because they will be the recipients of poor quality care even without their knowledge. For example, a nurse who is struggling with burnout can make mistakes when reading a patient’s record and fail to administer medicine that could prevent opportunistic infections that can occur in a patient under treatment for another condition. For instance, a patient with a wound or burns will need to a prescription to prevent infection by bacteria that enters into the body through the damaged skin. A nurse who fails to administer the medication because of distraction by burnout increases patient infection rates.

Managing  Pediatric  Pain:  One  plan  does  not  fit  all

Managing Pediatric Pain: One plan does not fit all

Pain occurs when the body develops feelings of hurt or intense discomfort. It is a way of sending a message about the occurrence of an injury to the brain. Managing pediatric pain or any other involves blocking of these messages or reduces the effect on the mind.

Pain management is essential because failure to take action makes the body to release some chemicals that might delay healing from the cause of the hurt such as surgery, injury or broken bones. Parents, pediatric nurses, and doctors should work together to determine and follow up with the best plans for controlling pain.

The best plan depends on the child, cause, and level of as one method does not fit everyone.

Pharmacological method of managing pediatric pain

1.Pain medications

Some of the pain medications are available over the counter while other others require a prescription by a doctor. Opioids are the category of pain-relieving medicine that requires a prescription by a physician and is not on sale over the counter. An opioid is a narcotic pain reliever containing natural synthetic or semi-synthetic opiates for some types. An opioid is often for treating acute pain such as that occurs for a short term after surgery. Children who are not 12 years old yet should not take Tramadol or codeine for pain or a cough. Teenagers who are under 18 should avoid Tramadol after a tonsil or adenoids removing surgery.

Acetaminophen (Tylenol) pain-relieving medicine is available over the counter although doctors also recommend some of OTC medications. Doctors might also recommend OTC or prescription strength NSAIDs like ibuprofen. Aspirin is not safe in children and teenagers who are below 19 years unless it is on instruction by a doctor. Aspirin at this age can cause Reye’s syndrome if a patient takes it during or after fever –causing or viral illness.

2.Patient-controlled analgesia (PCA)

Children at the age of 4-6 years can take PCA with the help of a nurse or parent. Children of six or more years can use a PCA pump to take medicine without help but might require supervision in the first days.

3.Antidepressants

These are drugs that treat pain and emotional conditions by adjusting levels of natural chemicals (neurotransmitters) in the brain. These medications might increase the availability of bodily signals to promote relaxation and well-being. Antidepressants help to manage pediatric pain in instances of chronic pain conditions that do not entirely respond to usual treatments.

4.Epidural Analgesia

Epidural analgesia is a pain medication that a doctor injects into the epidural space of spinal cord. Doctors usually perform it around significant surgeries such as spinal, abdominal or low extremity surgeries to control postoperative pain.

Some of these above medications are similar to those that adults take to manage pain, but the dose for pediatric administering is smaller to match the patient’s weight. Adhering to the dosing prescription by a pediatrician is essential.

Managing Pediatric Pain with Non-Pharmacological Therapies

Various therapies can help in addition to medical help to decrease pain in a child. The primary healthcare provider will participate in choosing the treatments that suit the infant. Each therapy might suit children of specific age groups.

The many therapies that can help to manage pain are:

Ice: Applying ice on a painful body part reduces pain, swelling and might prevent tissue damage. The method of application involves placing an ice pack or crushed ice set in a plastic bag before covering it with a towel and putting it on the painful section for 15 -20 minutes. A physician might recommend placement for a longer time.

Heat: Heat helps to decrease pain together with muscle spasms. It works when someone applies heat to the painful area for 20-30 minutes every two hours for the days that a healthcare provider directs.

Transcutaneous electrical nerve stimulation (TENS): TENS is a pocket-sized portable device that uses battery power which relieves pain by emitting mild and safe electrical signals that help in controlling pain. It attaches on the child’s skin after placement over the area of pain.

Massage therapy: Massage helps to relax the muscles of a child and decrease pain.

Physical therapy: exercising decreases pain by improving movement and strength.

Relaxation exercises and distraction of attention to other things other than pain help in managing pediatric pain if it is not severe. Pharmacological and non-pharmacological methods complement each other in instances of chronic pain.

How  Long  Should  a  College  Admissions  Essay  Be?

How Long Should a College Admissions Essay Be?

An admissions essay demonstrates the characters in addition to academic qualifications that make a student to be an excellent candidate for admission. It explains the reason why a student has an interest in pursuing a course at a particular college and the value he or she will add to the institution.

An appropriate length of a college admissions essay for a college admissions essay should be close to the word limit as possible. A writer should think of it within 50 words as lower bound and word limit as the upper restricted.

The shortest word limit for college essays at most colleges is around 250 words which fit is less than half of a single-spaced page. The maximum number of words is 650 words at most colleges. The word limit usually is around 600 words fitting slightly over a single-spaced page. There could see many things that an applicant can write, but admissions essays should stay short as admissions officers receive lots of them and must read everything.

Writing within the range of words in the instructions is essential. For instance, if the word limit is 500 words, it is essential to write about 450 -500 words.

College essay prompts usually have a word limit in the instructions or prompt. For example, some colleges might provide a prompt that requires the applicants to explain their interest in the selected area and describe the recent explorations and ways of developing this interest within and outside a classroom.

Applicants can explain the way their major will relate to their future career goals. Students who apply to general studies should explain their academic interests, strengths, and future career goals. They might include any areas or majors they are considering. They should limit their response to 300-400 words. If there is word range in the prompt, writers should stay within it.

Writing Over or Under the Word Limit of a College Admission Essay

Applicant should restrict their writing to word count in the prompt but can probably get away with exceeding by a few words when there is a need to attach a document. Some colleges do not have misgivings if some admissions essays exceed the limit by a few words. However, the safest option is to write without exceeding the word limit unless there is an explicit reason for the allowance.

Risk of exceeding the word limit

It might be impossible to fit all the content if the admission essay requires copy-pasting into a text box. The last part of the essay might be cut off creating a need start finding a way of trimming down. Another risk of going overboard is that an admissions counselor might decide not to read an essay beyond the word limit range.

Writing under the limit

It is probably fine if an applicant can get the point across beneath the word threshold. Brevity is now always a bad thing when writing an admissions essay provided that the content is clear, convincing and communicates the reason for writing.

Nonetheless, most of the college essays have extremely tight word limits. For instance, it might be more helpful to determine if there is something more to support or elaborate the points if an admissions essay reaches just 300 words when the limit is 500 words. A teacher, parent or a friend can help to identify more details or expanding a point that will help to eliminate the large gap in the actual and required work range.

It is also essential to reach the bottom end of the word range if a college provides the minimum number of words. For example, the requirement for an applicant is that they write 400-500 words. It is essential to reach the 400 words, or it might appear as if there was nothing else to say which not an impression that an applicant should create

Following directions is an essential part of a college application process including the word limit. Applicant should make sure that they within the word limit achieve the following:

  • Answer the essay’s question or complete the argument
  • Achieve flow and cohesiveness
  • Demonstrate unique qualities that will add something to the college

A college admissions essay should have examples to create a visual depiction of the things that an applicant has gone through and their impact in showing the way it has contributed to an interest in the college.

How  to  Make  Your  Writing  More  Interesting  for  Middle  School

How to Make Your Writing More Interesting for Middle School

Middle school is an academic level for children around 9-13 years which someone can consider to be a junior high school.

Children at this age should be writing something coherent and enjoyable to read. Teachers, parents, and guardians can make students of the middle school write work that is more interesting by encouraging writing both at home and school. The students should always have something to write even if it is not extensive for them to develop writing skills and eliminate intimidation. They can enhance their writing skills by trying short stories of entertainment, journal entries every day, best wishes cards and poems among others.

Teachers can play an essential role in improving writing skills by encouraging more writing from elementary class. The learners can begin by writing short stories on simple subjects like a favorite pet. Middle-class students should also make their writing more interesting.

Tips To Make Writing More Interesting For Middle School

An interesting topic

An interesting topic at hand makes writing to be simple, and the enthusiasm in the writers makes the piece interesting even to the readers. Writing something that you find interesting simplifies writing. Lack of exciting subject makes the writer draft sentences that deliver nothing even when they sound meaningful.

The reading material at the middle school is more intense than at elementary level. An excellent way to determine an exciting thing to write is to read widely from various materials and take notes. It is from one of these materials where you find and a topic with compelling information to share with the readers.

The topic and content should be specific because it engages the readers than something ambiguous that causes the reader to get divided attention. For example, these two sentences describe fruit trees in a garden, but one is more specific.

1.The garden has a lot of fruit trees.

2.The garden has 10 varieties of fruits including oranges, guavas, lemons, guavas, and blackberries.

The sentence with more specifics makes readers imagine an appearance on the garden.

Use of simple words

It is interesting to read something that is in a simple to understand language because of quick grasping of issues. Writing with pompous language for middle school reduces readability and makes the work boring as it is not easy to understand. A writer for middle school should use simple words like near but not proximity, help but facilitate and start or begin instead of commencing. A writer can use longer words but when the meaning is precise, and no other words will fit.

Writing in short sentences

Sentences for this level of writing should be short because they are simple to understand. Each sentence should have a simple thought. It creates complexity and confusion to place more than a straightforward idea in a sentence.

Maintaining short paragraphs

The paragraphs like sentences should also be short and mostly elaborating on one idea or those that relate closely. You can read newspapers to determine the significance of short paragraphs. The purpose of the short sections is to simplify reading which because brains absorb information better when it is in small chunks. A paragraph when developing scholarly work develops one idea and may include many sentences. Casual writing is less formal hence paragraphs can be short as one sentence or even a word.

Use of active voice

Writers who are writing in English should write in an active voice that follows the subject verb object (SVO) sequence because it captures the reader's mind than passive voice. Passive voice reverses the active course to object, verb, subject (OVS) sequence, and readers find it annoying. It might be impossible to write in an active voice all through, but writers should use it much as possible.

Ending with a memorable conclusion

A conclusion should be captivating to bring and summarize the work with the last perspective on the topic. A determination should have three to five sentences that review the main points, reinforce the thesis but without introducing new words.

Although a writer might want to ‘decorate’ the work for middle school kids, it does not serve a purpose to use fluffy qualifying words that do not add anything to the meaning because they will suck the life out of the sentences. For instance, there is no need to write "it is vital to avoid the empty fluff words as they are distracting." The words rather and are qualifying words that do not add any value to the work.

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