Clinical Reasoning Skill Question and Answer 2022

Running head: CLINCIAL REASONING SKILL
APPLYING CLINCIAL REASONING SKILL IN A CLINICAL PATIENT SCENERIO
Name of the Student:
Name of the University:
Author’s Note:

1CLINCIAL REASONING SKILL
Table of Contents
Answer 1.1.................................................................................................................................2
Pathophysiology of acute pain...............................................................................................2
Difference of pathophysiology of acute pain from acute pain...............................................2
Pathophysiological effect of narcotic analgesia.....................................................................2
Answer 1.2.................................................................................................................................3
Rationale of three types of nursing assessment......................................................................3
Answer 1.3.................................................................................................................................4
Three nursing interventions to improve physiological outcome............................................4
Answer 1.4.................................................................................................................................5
Administration of morphine...................................................................................................5
Benefits of morphine..............................................................................................................5
Risks of morphine..................................................................................................................6
Contradiction of morphine.....................................................................................................6
Education on patient controlled analgesia..............................................................................6
Answer 1.5.................................................................................................................................6
Major side effects of intravenous morphine...............................................................................6
References..................................................................................................................................8
Table of Tables
Table 1: Nursing assessment with rationale...............................................................................4
Table 2: Nursing intervention with rationale.............................................................................5

2CLINCIAL REASONING SKILL
Answer 1.1
Pathophysiology of acute pain
Acute pain occurs due to tissue injury. This is the result of peripheral pain receptor
activation. The pain lasts usually for three to six months and it also may be the result of
damage of acute tissue. Rowe and Schiller (2020) mentioned that th4e acute pain is keen in
quality. Hence, it is necessary to treat the underlying causes first to treat the acute pain. At
the location of injury, neurochemical reactions turn on free nerve endings of nociceptors that
are the special nerves. Tis nerve enters spinal cord and pass it to the higher order neurons. By
this process pain sensation reaches to the cerebral area and afferent information occurs in
different areas. After interpreting the impulse, response signal is yielded and travelled via
descending spinal tracks and pain sensation occurs.
Difference of pathophysiology of acute pain from acute pain
Chronic pain and acute pain is not similar. Chronic pain lasts more than six months
and can continue after healing the injury. Porela-Tiihonen et al. (2017) opined that chronic
pain is related with the ongoing tissue injury. Constant activation of those fibres can cause
chronic pain. However, Gan et al. (2018) suggested that severity of the tissue injury cannot
predict the severity of pain whether it acute or chronic. Chronic pain can result from the
ongoing injury or dysfunction of central or peripheral nervous system. It can be for week or
months or years. On the other hand, acute pain lasts for six months and goes away after
healing of injury. Chronic pain can occur due to nerve pain, cancer and arthritis whereas
acute pain can occur due to surgery, burns and cut.
Pathophysiological effect of narcotic analgesia
The pathophysiological effects of analgesia principally mediated via mu and kappa
receptors in the peripheral nervous system and central nervous system (Farmer et al. 2018).
Analgesia is one type of opioids that binds ad enhances the neurotransmission. As Tran is
getting narcotic analgesia, there can be few side effects like nausea, dizziness vomiting,
respiratory depression, analgesia-induced bowel syndrome, constipation and also can affect
other body functions. However, Narcotic analgesia prevents excess pain by interfering
normal biological functions. From the vital signs of Tran, it is found that his pulse is irregular