Patient Context Study | Assignment

Patient context
Mrs Caroline Morris is a patient who has arrived at the GI ward from recovery postoperative
bowel resection with LLQ ileostomy formation. Mrs Caroline has had ulcerative colitis since
teenage, and the condition worsen last year leading to surgery. She used to work in information
and technology until last when she became unable to work due to her medical condition. She is
worried if her partner will still finder her attractive. Her daughter is also with her and very
concerned about her.
Collected cues
Mrs Caroline;
 Has a pain scale of 8/10 and feels reluctant to use her pain control analgesia (because the
nurse told her it could be addictive, cause nausea and can even stop breathing)
 Feels weak, tired and miserable all the time
 Is anxious about having the ileostomy
 Is literate (worked in information and technology)
Medication
Norspan contain Buprenorphine. Buprenorphine is a partial agonist at the mu receptor (Butler,
2013). It is also a weak kappa receptor agonist and delta receptor agonist. It acts in the central
nervous system and is used in the management of moderate to severe pain (Hans, G., 2013). It is
suited for transdermal delivery its high lipophilicity, high potency and low molecular weight.
Each patch should be worn for one week (7 days)
Script Justification
Good morning Mrs Caroline, my name is
John, and I am a Registered Nurse. How are
you feeling today?
Introduction and greeting the patient helps in
building a rapport while talking to the patient
(Silverman et al. 2016)
I am feeling quite good; however, I still feel a
lot of pain.
Am sorry for that. I understand that you were
not comfortable with the morphine
Being emphatic is also a factor in establishing
a rapport (Djenar, 2019). It shows the patient

medication for pain, and I have brought you a
new drug.
that you understand how she feels and gives
her more comfort.
Yes, I am afraid of the side effects it can lead.
Tell me more about the drug you have
brought.
Wonderful, the side effects may not be that
good. I came so that I can talk to you about
the drug before you can start using it.
It would take a few minutes. Would it be okay
if I sit down? Make sure you seek
clarification where you do not understand and
ask questions freely as we go through this.
Repeating what the patients said helps her
know that you are listening and will be
willing to continue the discussion (Fortin et
al. 2012). Seeking clarifications and asking
questions would help the patient understand
the drug information better (Dunn, and
Conard, 2018.)
Okay, it will be great to know everything that
concerns.
Wonderful, so the medication is Norspan, a
drug that is used to relieve severe pain for
people would need pain medication from time
to time and when other medications cannot be
used.
Remember you had a pain scale of 7-8/10 this
morning and you no longer need morphine?
So, this would suit you better.
Telling the patient, the drug name and its uses
are important. It helps her understand why it
has been prescribed to her (DiMatteo et al.
2012).
How is this different from the one I am
currently using, and how will I use this?
Norspan comes as a patch and is applied to
the skin once a week. You can apply it to
upper chest, upper outer arms, the side of
your chest or even upper back. Choose the
part of the skin that is flat and has no hair.
The part applied should not be damaged,
irritated or changed in any way. Once applied,
The management of the patient becomes
easier when she understands how the drug is
used since she will cooperate better
(Malamed, 2017.)