Scribd
Upload
68 views2 pages

Post-Op Pain Management Plan

The patient reported ongoing abdominal pain following surgery. The nursing assessment found the pain level was 9/10. Inflammation from the surgical incision was causing the release of substances like bradykinin that transmit pain signals to the brain. The nursing plan was to use non-pharmacological interventions like music therapy and guided imagery to decrease the pain level to 7/10 within an hour. The nurse would also administer analgesics as approved and monitor the patient's response to the pain management.

Uploaded by

KyleDominicKohGo
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
68 views2 pages

Post-Op Pain Management Plan

The patient reported ongoing abdominal pain following surgery. The nursing assessment found the pain level was 9/10. Inflammation from the surgical incision was causing the release of substances like bradykinin that transmit pain signals to the brain. The nursing plan was to use non-pharmacological interventions like music therapy and guided imagery to decrease the pain level to 7/10 within an hour. The nurse would also administer analgesics as approved and monitor the patient's response to the pain management.

Uploaded by

KyleDominicKohGo
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

ASSESSMENT Subjective: sakit padin ng tiyan ko as verbalized by the patient

DIAGNOSIS Acute pain related to surgical incision as evidenced by pain scale of 9/10

SCIENTIFIC EXPLANATION Inflammation of the appendix surgical incision release of chemical substances such as bradykinin bradykinin binds to prostaglandin and histamine transmit the signal to the spinal cord transmit to medulla oblongata perception of pain

PLANNING Short term: After one hour of nursing intervention, the pt. will be able to: -decrease the level of pain from 9/10 to 7/10. -verbalize non pharmacological methods that provide relief such as music therapy and guided imagery.

INTERVENTION Independent: -Assess the patients description of pain -determine the clients acceptable level of pain -encourage verbalization of feelings about pain -encourage relaxation techniques like focused breathing and diversion of activities -provide comfort measures such as back rub, guided imagery and music therapy. Collaborative: -Administer analgesics as indicated to the maximum dosage, as needed. -Evaluate the pt. response to analgesia, and assist in transitioning/ altering drug regimen based on individual needs.

RATIONALE Independent: -to have a baseline assessment -to assist pt. explore methods for alleviation of pain -aid in controlling pain -to provide non pharmacological pain management

EVALUATION Short term: After one hour of nursing intervention, the pt. was able to: -decrease the level of pain from 10/10 to 7/10. Goal partially met, continue the plan -verbalize non pharmacological methods that provide relief such as music therapy and guided imagery. Goal met, terminate the plan. Long term: Upon discharge, the pt. was able to be free from pain as manifested by pain scale of 0/10. Goal partially met, continue the plan.

Objective: -2 days post-op -facial grimace -weak looking -muscle guarding on the abdomen part -restlessness P- surgical incision Q-gnawing pain R-LUQ S- 9/10 T-continuous

- to provide non pharmacological pain management Collaborative: -to maintain acceptable level of pain. Notify the physician if the regimen is inadequate to meet the pain control goal. -increasing/ decreasing dosage, stepped program helps in self management of pain.

Ref: Brunners Med. Surg. 11th edition. Volume 1.

Long term: Upon discharge, the pt. will be able to be free from pain as manifested by pain scale of 0/10.

You might also like