Pathophysiology of Acute Pain and Pharmacological Management

This assignment focuses on the pathophysiology of acute pain and the pharmacological management of a specific health problem. It includes a case study of William Tran and explores the different treatment options for acute pain.

Nursing

INTRODUCTION
Nursing refers to a medical professional to gain license of a nurse by gaining respective
degree or diploma to provide care for patients to make them healthy (Gorawara-Bhat and et. al.,
2017). This assignment is based on the case study of William Tran having situation of post-
surgical dependency after ileostomy. It will focus on pathophysiological changes and
pharmacological management of particular health problem.
TASK
1.1 Describe the pathophysiology of acute pain. How does this differ from chronic pain? Include
in your answer the pathophysiological effects of narcotic analgesia as a treatment option
for acute pain. Demonstrate links to Tran’s case.
The acute pain can be defined as a condition when quick and sharp is experienced by an
individual. It can be considered as a broad term that is known to be a mild to sharp pain which
can comes on suddenly. Meanwhile, acute pain may recover within few minutes or may remain
active for a couple of months. It includes the pathophysiology of acute pain includes symptoms
such as flu like signs including fatigue, numbness, muscle spasms, insomnia, weight loss, anxiety
and depression (Crawford and et. al., 2016). However, the problem of acute pain occurs due to
number of causes including accidentally touching hot stove, slamming finger in door, labour
pain, accidentally have cut anywhere on body, post-surgical pain at surgery site and many more.
Acute pain takes short period of time in order to heal the same.
The diagnosis of acute pain involves to examine the patient by evaluating patient complain
about pain, appetite changes, facial mask of pain, and other vital signs. The Tran shiws several
symptoms like Temp 35.8, Pulse irregular 110 bpm, BP 98/55, RR 6, SaO2 93% 6Lt oxygen via
Hudson mask. He is difficult to rouse and remain no-verbal due to pain. In context of Tran’s
condition, the acute pain can be healed with the help of using several clinical procedures like
behavioural therapy, biofeedback, electrical stimulation, physical therapy, psychotherapy,
relaxation techniques, surgery and acupuncture. The patient depend for mobility due to having
pain then it can recovered by using acupuncture and physical therapy for wellbeing of William
Trans.
In contrary to this, chronic pain is different from acute pain in terms of its severity and its
existence for long duration. Chronic pain can be considered as a condition that persist even after
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an injury or surgery has recovered with active pain signals remaining in nervous system for
weeks, months or even years. Basically, it is observed that chronic pain is severe as compared to
acute pain and it may leads to extra emotional and physical effects on human body like sore &
tends muscles, limited mobility, depressions, anxiety etc.
In addition to this, the narcotic analgesia can be used for reliving the pain of William Trans
to improve their comfort level that facilitate to heal with surgical wounds. It is observed that
narcotic analgesia is much effective to be used for relieving moderate to severe acute or chronic
pain. However, the pathophysiological effects of given medication is that the narcotic analgesia
is responsible to bind with opioid receptor, part of opioid system which has function to control
pain, pleasurable and addictive behaviour in human beings (Riemondy and et. al., 2016). It is
helpful to manage the acute pain condition of William Trans which facilitate improvement in
their ability to move that helps to eliminate dependency to move.
1.2 Discuss three types of nursing assessments in order of priority that would be appropriate for
Tran’s deterioration (excluding vital signs) and provide description of each of these in the
context of Tran’s complaint with rationale as to why these would be your priority.
The nursing assessment to diagnose the features by several symptoms indicated by selected
patient for evaluating their actual situation. It includes the several aspects to assess the problem
of William Tran in order to treat their problem of acute pain. Basically, it is necessary to analyse
patient complains of pain which is not applicable in case of Trans because he was non-verbal. It
consist the examination of appetite changes, self-focussed, guarding behaviour, intolerant facial
mask of facial pain, autonomic responses, changes in muscle tone, lethargy or weakness, rigidity
or tightness and relief or distraction behaviour including pacing, seeking out other people or
activities accordingly. However, the Tran’s condition can be evaluated by examining expressive
behaviour which is suitable for given patient’s situation because he is not able to communicate
his problem and difficulty experienced. It has been analysed that hopelessness, observed
evidence of pain through using standardised pain behaviour checklist (Mackintosh-Franklin,
2017). Meanwhile, it includes the use of several assessments for those people who are not able to
communicate like William Tran such as behavioural pain scale, neonatal infant pain scale, pain
assessment checklist for seniors with limited capability to communicate to understand their
actual condition. It will provide support to make appropriate decision for wellness of Tran.
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On the other hand, it has been analysed that positioning of patient to avoid pain should be
examined, protective gestures and proxy reporting pain as well as behavioural changes. The
priorities signs of William Tran include his acute pain, mal-absorption and weight loss in order
to improve their medical, it is required put these three priorities important while establish
effective plan of care in terms of managing the problem of acute pain in given case of the patient.
It is necessary to focus on these symptoms for provide better quality of care for making given
patient disease free (Fry, Chenoweth and Arendts, 2016).
1.3 Discuss three nursing interventions (may include one pharmacological) you would initiate
and provide rationale as to how these would improve physiological outcomes of Tran’s
problem. Nursing interventions would include nursing activities or actions that the nurse
could initiate in response to nursing assessment findings.
The severe pain is experience by William Tran following post-operative condition due to
which he was facing difficulty in explaining the pain. It includes the condition of patient when
they are non-verbal and not capable to define the acute pain. However, it has been examined that
given patient shows several symptoms such as Temp 35.8, Pulse irregular 110 bpm, BP 98/55,
RR 6, SaO2 93% 6Lt oxygen via Hudson mask. It consist the utilisation of effective care plane in
order to deal with different symptoms of an individual it is necessary to consider several care
priorities like acute pain, mal-absorption and weight loss. The physiological condition of Tran
includes the problem of dependent mobility which is required to be improved by healing the
acute pain. Moreover, it includes focus on pain that helps to overcome with different symptoms
of patient like loss of weight, mal-absorption and dependent for mobility to make them
completely fine respectively.
The nursing interventions for relieving acute pain related to post-surgical problem require
use of pharmacological methods including non-opioids (acetamoniphen) including NSAID helps
in stimulating the nociceptors and effective to manage mild to moderate pain. It consist the
utilisation of opioid analgesics in order to relive the symptom of severe pain especially in
hospice or home settings (Brant and et. al., 2017). Meanwhile, it includes the way of
implementing local anaesthetic agents that are responsible for blocking transmission and nerve
distribution in particular areas. It involves the utilisation of non-pharmacological intervention by
considering cognitive behavioural strategies such as imagery, distraction techniques, relaxation
exercises, biofeedback, breathing exercises, music therapy etc. It is beneficial to divert the
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stimuli which helps reduce the pain of an individual. It involves another intervention of
cutaneous stimulation by several practices like massage of affected areas when suitable,
transcutaneous electrical nerve stimulation units, hot or cold compress and many more. These
interventions are helpful to manage the acute pain in case of William Tran that facilitates to heal
the other symptoms like non-verbal condition, weight loss and mal-absorption. It is also
favourable to improve mobility of patient which decreases their dependency to move.
1.4 Discuss the administration (including administration, benefits, risks and contraindications) of
Morphine for Tran’s pain. Include your explanation what education you should provide to
Tran’s on commencement of the patient controlled analgesia (PCA).
The morphine can be defined as a kind of drug that belongs to opiate family which can be
extracted from some of plants and animals. It includes the use of morphine as a medication in
order to treat severe pain. It can be considered as narcotics an analgesic which has a role to
works in brain of human body in respect of changing the way of body feels as well as responds
to pain. Meanwhile, it has been analysed that the administration of morphine can be carried out
through oral method and via injection (Hunter and et. al., 2017). It can be used by intravenous
mode in order to relive the symptoms of severe pain experienced by Tran in given case scenario.
However, the benefit of morphine is known as to treat severe level of pain among patients
suffering from acute or chronic pain in proper manner. It is necessary for patient to use this
medicine as per prescription and stop it’s used in proper way to avoid side effects.
The morphine has a property to relive the symptoms of severe pain but it is a risky
medicine because its side effects. It includes developing the several symptoms such as nausea,
vomiting, constipation, light-headedness, dizziness, drowsiness, increased sweating or dry mouth
condition may occur (Nottage and et. al., 2016). The kind reactions may occur like pain, redness
or swelling at the injection site. However, it should ensure to use specific amount of dosage with
taking precautions to avoid side effects while providing Tran’s on commencement of patient
controlled analgesia.
1.5 Report the major side effects of intravenous morphine apply your findings to Tran’s case.
Explain why this finding would need to be reported immediately to the Doctor.
The morphine has ability to heal the acute pain condition in case of William Tran to improve
their health condition. It includes the major side effects which are observed in given case were
sleep apnoea, vomiting, nausea etc. which are responsible for reducing patient experience. By
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observing these symptoms, doctor is required to be call immediately to deal with the situation for
making patient stable by providing quick medication. However, the side effects of morphine
were overcome with using other medications and therapies for making patient disease free.
Moreover, it has been analysed that there are many of other major side effects which were
observed in other people such as sleep apnoea, mood changes including agitation, confusion,
hallucinations, difficulty in urination, vision changes, slow & fast heartbeat, severe abdominal or
stomach ache, symptoms of adrenal glands not working well like loss of appetite, unusual
tiredness and weight loss.
CONCLUSION
From the above essay, it has been concluded that acute pain is a condition when a person
experience sudden pain at specific site on body. This kind of pain required few of days or weeks
to overcome with the same. However, the use of morphine is favourable to deal with acute and
chronic pain but use of this medication should be done very carefully to avoid its side effects.
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REFERENCES
Books and journals
Gorawara-Bhat, R. & et. al. (2017). Nurses’ perceptions of pain management for older-patients
in the Emergency Department: A qualitative study. Patient education and counseling, 100(2),
231-241.
Crawford, C. L. & et. al. (2016). An integrative review of pain resource nurse programs. Critical
care nursing quarterly, 39(1), 64-82.
Riemondy, S. & et. al. (2016). Nurses' perceptions and attitudes toward use of oral patient-
controlled analgesia. Pain Management Nursing, 17(2), 132-139.
Mackintosh-Franklin, C. (2017). Pain: A content review of undergraduate pre-registration nurse
education in the United Kingdom. Nurse education today, 48, 84-89.
Fry, M., Chenoweth, L., & Arendts, G. (2016). Assessment and management of acute pain in the
older person with cognitive impairment: A qualitative study. International emergency
nursing, 24, 54-60.
Brant, J. M. & et. al. (2017). Nurses’ knowledge and attitudes about pain: Personal and
professional characteristics and patient reported pain satisfaction. Pain Management
Nursing, 18(4), 214-223.
Hunter, O. O. & et. al. (2017). Overcoming nursing barriers to intensive care unit early
mobilisation: A quality improvement project. Intensive and Critical Care Nursing, 40, 44-50.
Nottage, K. A. & et. al. (2016). Addressing challenges of clinical trials in acute pain: the Pain
Management of Vaso-occlusive Crisis in Children and Young Adults with Sickle Cell Disease
Study. Clinical Trials, 13(4), 409-416.
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