Nursing Assignment on Pain Assessment

This nursing assignment discusses the importance of proper assessment in nursing care for arthritis patients. It covers the physical, psychological, and spiritual aspects of assessment and the ethical framework of nursing care. The six C's of nursing care are also highlighted for better patient outcomes.

Nursing Assignment on
PainAssessment

Table of Contents
Introduction...........................................................................................................................................2
Discussion.............................................................................................................................................2
Patient description in relation to care setting.....................................................................................2
Assessment of the patient..................................................................................................................3
Ethical framework.............................................................................................................................6
Information and tools used................................................................................................................6
Physical, psychological and spiritual aspects of the assessment........................................................7
Conclusion.............................................................................................................................................9
References...........................................................................................................................................10
Appendices..........................................................................................................................................12
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Introduction
Osteoarthritis is a degenerative pain that severely affecting the old aged people around the
world. The symptoms are unusual swelling, tenderness and the crackling painful sound of
joint during movement. A recent study has disclosed that around 57% of the old aged people
of the UK use to suffer from osteoarthritis after the age of 60. Necessity care is required to
get recovered. According to the case study, a patient of 72 years old is admitted to the
hospital with immense pain and is diagnosed with arthritis. Knee replacement is the option by
which the pain can be reduced. The patient is admitted to the arthritis ward. Proper nursing
care had been performed following the core principles of nursing so that the patient can be
cured in a limited time frame. Six C’s of nursing involves proper assessment of the vital
statistics of the patient and it should be done properly. After assessing the situation, the
diagnosis should be done and in this case, pain is the main focus point. The reason for pain of
the 72 years old patient and the area of pain should be diagnosed. Holistic nursing care
should be provided to the patient according to the diagnosis. Subsequently, after the diagnosis
is done an evaluation of the implementation process should be done so that necessary
modification can be made according to demand of the situation(Ackley and Ackley-Ladwig-
Swan-Tucker, 2008). The main focus of the study is to develop nursing care for old aged
people who will go under knee replacement.
Discussion
Patient description in relation to care setting
The recovery of osteoarthritis depends on the effective care from the caregivers. It requires
proper care, medication, and advice on healthy lifestyle. According to the case study, the
patient is an old aged lady of 72 years old. She is suffering from arthritis which causes severe
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pain. Since the patient is a very old aged woman, proper care should be taken 57% of the
people who are 60 years are suffering from osteoarthritis. Since she is growing through
immense pain, the care setting should possess some basic facilities. Besides this, the basic
parameters like the blood pressure, blood sugar, and heart rate, pulse rate should be
monitored in a regular interval. Pain relief medication must be provided to the patients as
initial treatment. (Stephen, Wilcock and Wimpenny, 2012).
Most of the patients with osteoarthritis have a problem with walking. Due to frequent walks,
there is an increase in the pain so the patient will have to stay in bed till her knee is replaced.
Proper communication is required for the patient. Empathetic care should be given to the
patient and her old age should be considered. Since the patient is of so old age proper
empathetic communication is required so that the patient can tell freely about her condition.
If free and homely environment prevails in the nursing care, it will help the lady to describe
her pain in detail which will help the nurse to take appropriate measures to mitigate the
situations (Ackley and Ladwig, 2014).
Assessment of the patient
Nursing care is totally based on the proper assessment of the patient. The patient and the
medical history of the patient must be assessed properly for effective treatment. According to
the case study of the old lady of 72 years should be assessed properly in a holistic manner.
The symptoms of the lady should be checked and the region of the pain should be specified
so that proper the real condition and intensity of the pain can be comprehended. The
assessment of physical parameters should be done if the total knee replacement decision is
taken. Before any surgery, there are some physiological tests which are done to assess the
present situation of the patient. In this case, the assessment should be done after that
operation will be confirmed(Basford and Thorpe, 2004).
The nurse should take into account the following parameters forfurther assessment.
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Present condition and fitness level: The fitness level of thepatient is an object and the pain
that is occurring is subjective. The intensity of the pain of the 72 year old patient should be
analyzed and monitored properly. Inference should be drawn from this data's that the patient
likelihood of going through surgery. If the intensity of pain is huge then some short-term
measures like massage and application medication should be done.
Background risk assessment: Background risk assessment should be done properly. It is
known that the total knee replacement operation of the 72 years old lady patient can get
complicated with patients having a cardiovascular problem or renal problem. Proper
physiological test like ECG, EEG should be done to assess the condition of the heart. Urea,
create nine and another physiological test regarding the renal system should be done to assess
the present condition of the patient (Coffey and Whitehead, 2015).
As the case study mentioned, the 72 years old patient requires sufficient and bias less care
from the nursing caregivers in order to recover soon. She must be provided with her meals
and medication properly for a better outcome. Moreover, there is a necessity to provide her
motivation, mental satisfaction, and religious satisfaction every day for her mental and
spiritual development. In this occasion, care, compassion, communication, courage,
commitment, and competence must be showed to her to make her pain relief procedure faster
(Shippee-Rice, Fetzer, and Long, 2012).The patient must be providing sufficient care
according to the proper maintenance of six C's of nursing. She should be diagnosed with care,
compassion, competence, communication, courage, and commitment.
Care: Care must be provided to each patient without any biases. The 72 years old woman was
suffering from arthritis and was suffering from knee pain. Thus, she must need sufficient care
from the care staffs. Several care removal techniques must be applied to her based on her
type of pain and proper medication along with food must be provided.
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Compassion: Compassion signifies providing care with enough respect, empathy, and
politeness. Here the 72 years old patient is old aged; thus, she needs compassionate treatment
from the caregivers. Polite behaviors, providing her homely atmosphere and respecting her
individual choices and culture should be best practice on her (Doss, 2016).
Competence: The patients must need the competence to satisfy their social and health needs.
They should have the ability to understand the clinical requirements and social needs of the
patient to nullify the pain and deliver efficient care. As per the case study, the 72 years old
patient is suffering from arthritis pain. Thus, she requires effective competence from the
caregivers to develop her health situation.
Communication: successful communication with the patient is must need an element to deal
with the disease of the patient. Moreover, communication enhances the capability of team
working process. The nursing caregivers must listen to the problems that the old woman is
facing and needs to provide care according to the situation (Sharma, 2018).
Courage: Courage enables the nursing caregivers to do the ethical deeds for the patient at
right time. It can be helpful for the nursing caregivers to develop the interpersonal strength to
the patients so that they can find the innovative vision to deal with their physical problems.
As the case study mentioned, the courage of the 72 years old aged patient must be developed
to dwell with her arthritis pain (Dunning, 2008).
Commitment: The nurses must ensure commitment to the patient that they must effort their
level best for the wellbeing of the patient. The caregivers of the nursing care home must
commit to the 72 years old aged patient to do their best for her wellbeing and relief her from
the fatality of pain.
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Ethical framework
The basic principle of the nursing caregivers is to provide sufficient care to each patient's
respecting their dignity, consideration and help them to access relevant social and health care.
The patients generally expect to be treated kindly and modestly irrespective of their age,
gender, social and financial background. As per the case study the 72 years old patient has
gone through severe knee surgery and is prone to arthritis. Thus, she expectsto be treated
accordingly in a homely atmosphere. She expects that the nursing staffs would respect her
confidentiality, show concern to provide sufficient care to relief her from pain. Proper
communication with the patient must be applied by the caregivers to make the patient feel a
homely atmosphere. Communication must be developed with her in both verbal and
nonverbal manner so that she can feel free to connect the caregivers if pain arises. There must
be aware regarding the legislation related to the decision making the process of providing
sufficient nursing care treatment (Collins-Bride, Saxe, and University of California, 2013).
It is the right of the individual patient to get unbiased treatment from the nursing caregivers.
The process of treatment must maintain the ethical principles of nursing. The ethical
practices include
 Refusal of any kind of gift or bribe from the patient party
 Should not ask for any kind of loan from the patient or family of the patient
 Establishment of sexual boundary must be maintained
Information and tools used
There are various tools which the nurse should use to maintain the relationship between them
and the patients. The nursing caregivers must be efficient enough to communicate with the
patient properly; here the patient is suffering from arthritis pain which must be assessed
according to the adaptability and sharpness of the caregivers.
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 Adaptability: The nurse should change themselves as the hospital environment is
changing rapidly. Though they continuously experiencing the stress, they are
changing themselves with the technological advancement.The 72 years old lady
patient should be treated with updated technology and technical aspects for fast
betterment.
 Sharpness: The nurse should possess the sharpness mentality to cope with the stress.
Though they are diligent, they need to possess the patience to cope with the critical
situation(Jamison, 2006).To treat the 72 years old patient, a good amount of patience
is required. It would help the caregivers to give her efficient treatment for her arthritis
pain.
Physical, psychological and spiritual aspects of the assessment
Nowadays, it is heard sometimes that above the age of 60 years Arthritis is a common issue
for them. After the knee replacement, the 72 years old patient needs to take the serious
assessment. The nurse of the health care or nursing home should clarify the exact solution for
the physical, psychological and spiritual assessment (Lehne et al., 2007).
 Physical Assessment: To talk about the physical assessment, the nurse or the clinical
staff needs to note down specific exercise for this particular patients. They should
engage the suitable person for this particular physical assessment. The help of
machinery exercise can be taken. As mentioned in the case study, the clinical staff or
the nurse should know the proper execution of the machine or the technological
operation apart from their regular work. The nurse should do the massage of the
patients so that the patients can walk easily without feeling any pain. Apart from their
regular task, they need to perform other assessment which can help the patients to get
well as early as possible (Lothian, 2001).
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Picture: Refer to Appendix 1
 Psychological Assessment: The assessment of the psychological is very helpful in
managing the patients with arthritis. It is a testing process which mainly used to detect
the personality, behavior, and the capabilities of the patients. As the patients generally
have to go through some mental sufferings, so the psychological assessment is
essential for this case. By doing this assessment, the psychologist can understand the
whole mental condition of the patient who just been released from the treatment of
arthritis (Mize, 2017). The psychological assessment can be helpful for the patient
mentioned in the case study to tide over its painful times. The psychologist often
makes out of which section of that patient needs to take care of.
Picture: refer to appendix2
 Spiritual Assessment: Apart from the above-mentioned assessment, the spiritual
assessment is very important for the patient, particularly for the elder person. This
particular tool is very useful for curing the 72 years old patient of both ways mentally
and physically. The clinical staff should provide the Spirit and Soul overview to the
patients. They must provide compassionate care; they must make sure the spiritual
beliefs which can affect the choices of the treatment (Phelan, 2013).
There are many assessment tools that have been created by the expert to guide the clinical
staff to treat the patients properly.
The tool such as FICA which stands for
 Faith and Belief: This thing helps the 72 years old patient to reduce the stress and
bring the happiness to her life.
 Importance: The importance affects the self-belief of the 72 years old patient.
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 Community: The nurse or the clinical staff should make the 72 years old patient
understand the role of the spiritual gatherings in a life of the patient.
 Address in Care: This thing is very important to remember for the clinical staff. They
need to know the how to address the 72 years old patients about the cure process for
arthritis (Phillips, 2015).
Another tool namely HOPE, it focuses on how to interchange the religious beliefs within the
limited community. This also focuses on the spirituality of the particular person.
Conclusion
The study has analyzed here the various nursing ethics, nursing principals, and treatment. The
study has focused on the treatment of 72 years an old woman who is suffering from arthritis
pain and about to face knee surgery. To analyze the facts, various nursing care treatment for
pain-relieving has been identified in this study to treat the 72 years old patinet. The physical,
psychological and spiritual assessment of the patient has been provided in the study in order
to provide her relief from her excessive pain. Effective pain-relieving treatment is generally
based on providing sufficient care, empathy, and medication to the patient for an effective
outcome.
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References
Ackley, B., and Ackley-Ladwig-Swan-Tucker ... (2008).Evidence-based nursing care
guidelines. St. Louis: Mosby, Elsevier.
Ackley, B. and Ladwig, G. (2014). Nursing diagnosis handbook. Maryland Heights, Mo.:
Mosby.
Basford, L. and Thorpe, K. (2004). Caring for the Older Adult. London: Cengage Learning.
Coffey, A. and Whitehead, N. (2015).Healthcare assistants’ attitudes towards older people
and their knowledge about ageing. Nursing Older People, 27(1), pp.24-30.
Collins-Bride, G., Saxe, J. and University of California, S. (2013). Clinical guidelines for
advanced practice nursing. Burlington, MA: Jones & Bartlett Learning.
Doss, A. (2016). Could a disruptive out patient healthcare delivery model reduce escalating
in-hospital healthcare costs in knee osteoarthritis. BMJ Innovations, 2(2), pp.65-69.
Dunning, T. (2008). Nursing Care of Older People with Diabetes. New York, NY: John
Wiley & Sons.
Jamison, J. (2006). Health Care for an Ageing Population - ElsevieronVitalSource.Saintt
Louis: Elsevier Health Sciences UK.
Lehne, R., Moore, L., Crosby, L. and Hamilton, D. (2007). Pharmacology for nursing care.
[St. Louis, Mo.]: Saunders Elsevier.
Lothian, K. (2001). Care of older people: Maintaining the dignity and autonomy of older
people in the healthcare setting. BMJ, 322(7287), pp.668-670.
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Mize, D. (2017). The meaning of patient-nurse interaction for older women in healthcare
settings: A Qualitative Descriptive Study. International Journal of Older People Nursing,
13(1), p.e12167.
Phelan, A. (2013). Editorial: Primary healthcare for older people: editorial comments for the
International Journal of Older People Nursing. International Journal of Older People
Nursing, 8(2), pp.81-82.
Phillips, K. (2015). Predicting response to osteoarthritis treatment: Patient phenotype based
on patient reported outcome measures and quantitative sensory testing in a clinical
trial. Osteoarthritis and Cartilage, 23, p.A357.
Sharma, M. (2018). Conservative Therapy through Adequate Doctor Patient Interaction
Improves outcomes in Patients Suffering from Mild and Moderate Knee
Osteoarthritis. International Journal of Healthcare Education & Medical Informatics, 04(04),
pp.1-2.
Shippee-Rice, R., Fetzer, S. and Long, J. (2012). Gerioperative nursing care. New York:
Springer.
Stephen, A., Wilcock, S. and Wimpenny, P. (2012). Bereavement care for older people in
healthcare settings: qualitative study of experiences. International Journal of Older People
Nursing, 8(4), pp.279-289.
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Appendices
Appendix 1: Physical aspects of arthritis pain
Appendix 2: psychological aspects of arthritis pain
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