Mr. Hemsley's Case Study: Morphine, Nursing, and Post-Operative Care

This case study examines the care of Mr. Hemsley, a patient experiencing abdominal pain and undergoing various treatments including morphine administration and colostomy. The assignment addresses how morphine alters pain perception, detailing specific nursing responsibilities for its safe administration. It further identifies and discusses non-pharmacological interventions for post-operative pain management, such as positioning and hot-cold applications. Additionally, the study explores potential complications related to Mr. Hemsley's colostomy during the initial post-operative period, along with the associated priority nursing interventions. The study incorporates relevant references from books, journals, and online resources to support its findings and recommendations, providing a comprehensive overview of patient care in this scenario.

Case study questions

Table of Contents
QUESTION1.............................................................................................................................3
QUESTION2.............................................................................................................................3
QUESTION3.............................................................................................................................3
REFERENCES.........................................................................................................................4

QUESTION1.
 Describe how the administration of Morphine alters Mr. Hemsley’s conscious
perception of pain.
Mr. Hemsley, a 56-year-old male, generally presented to the emergency
department with having an abdominal pain, nausea as well as vomiting linked with the
recurrent episodes of constipation. Within the past four weeks, the patient has
experienced an unexplained episode of fatigue. He also observed that his stool
becomes narrow and long with having a small amount of bright blood on the toilet
paper as well. It is determined by the care professionals by performing the digital
rectal examination to simply rule out the haemorrhoids, the colorectal cancer or an
anal fissure as well. Mr. Hensley was generally subsequently admitted under the care
of a gastrointestinal specialist for further investigations as well as the management of
a pain. In this, a psychoactive drug such as Morphine is mainly a chemical which can
alters the state of consciousness, mainly the perceptions and moods of Mr. Hemsley.
These are generally prescribed by the healthcare professionals to the patients who can
not able to bear pain and to manage the pain of the patients, Morphine is given to
them. The medication generally influences the consciousness by simply making
affecting how the neurotransmitters can operate at the synapses of the central nervous
system. In this, many of the medications are agonists, that can mimic the operations of
the neurotransmitters, some of them are antagonists, that can simply block the actions
or activities of the neurotransmitters (Role of the nurse in supporting the safe use of
opioids, 2020). In addition to this, some can work by simply blocking the reuptake of
the specific neurotransmitters at the synapses. It is known that the patients who have
become physically dependent on the administration of morphine during the course of
the care treatment for having a painful harm or an illness that is able to speedily
weaned off the drugs afterward, without becoming addict. Hence, the administration
of the Morphine drug can effectively alter the conscious perceptions of pain of Mr.
Hensley.
 Discuss the three specific nursing responsibilities required for the safe administration
of Morphine.
The care nurses are generally involved in the administration of the drugs
across healthcare settings. The care nurses can also be involved in both the terms such
as dispensing as well as preparing the medications like crushing the pills as well as
drawing up a measured amount for the injections. In this, the very three specific care
nursing responsibilities that are needed for the safe administration of the Morphine as
such as determining the patient at risk for unintended advancing sedation as well as a
respiratory depression from the opioid therapy, executing an effective care plan to
assess as well as monitor the patients, and last, prevailing to prevent the deteriorating
of the adverse events as well. in this, the care nurses generally required to understand
the basic pharmacology, its side effects as well as the risks of the opioids in order to
ensure the safe administration of the medications. In addition to this, the drug therapy

can play an essential role in the care treatment of a patient. More traditionally, the
medications have been prescribed by the healthcare professionals as well as the
responsibility of the care nurses is to ensure safe as well as a reliable administration
and to effectively monitor the side effects as well. in this, the safety of the patients is
generally the key issue as well as the thrust of the reforms is to effectively benefit the
vulnerable patients by simply permitting them access to the medications. The care
service can benefit because the professional time is freed for those with the more
complex needs. Within the healthcare organization, the custody as well as the
administration of the medications is generally the responsibility of the care nurses
who may represent the responsibility which is specifically instructed by the policy of
the workers authority (Rivet, 2019).
QUESTION2.
 Identify and discuss the benefits of three non-pharmacological nursing interventions
which may be executed when managing Mr. Hemsley’s post operative pain.
The possible three benefits of the non-pharmacological nursing care
interventions which can be implemented when managing the case scenario of Mr.
Hemsley’s post operative pain such as the care nurses can apply the hot-cold
applications, positioning, effective physical activities, resting as well as the distraction
practices at an elevated rate. In this, it has been identified that the positioning method
is generally the most often used care method for the post operative pain control as
well as the positioning and exercise that can effectively contribute towards the
solution of the post-operative issues more specifically the pain. In addition to this, the
hot-cold application can be effectively used in the pain control because of the fact that
that it exhibits an effective action by effectively decreasing the ischemic pain,
removing the metabolic remains, enhancing the secretion of the endogenous opioids
and effectively eliminating the muscle spasm. In this, the distraction methods can
specifically enable the Mr. Hemsley to pay attention towards the things which they
like the most and ultimately can enhances their tolerance power towards pain as well
as can decreases the pain threshold effectively. there is a notion that the often-used
methods are more specifically taught repetitively within the nursing curriculum in
general and these such situations is naturally mirror to one of the care clinical settings.
In this, the use of non-pharmacological methods in the post operative patients was
generally determined based on the personal statements of the care nurses. Therefore, it
was particularly not aimed to identify whether or not these such care practices were
specifically applied completely and properly as well for Mr. Hemsley for whom the
management of the pain must be performed in the post operative times. There are the
care treatments other than the pharmacological, such as exercise, acupuncture, hot
applications and many more by the care nurses to treat Mr. Hemsley in order to
reduce his pain more effectively. Moreover, by executing such applications and
methods on Mr. Hemsley can reveal that the non-pharmacological interventions or
methods can also play an essential part in reducing the pain more efficiently
(Determining the Use of Nonpharmacologic Methods by Surgical Nurses for
Postoperative Pain Management and the Influencing Professional Factors, 2019).

QUESTION3.
 Identify and discuss the two possible complications and its linked nursing
interventions of priority when managing Mr. Hemsley’s colostomy during the first 24
to 48 hrs post-operatively.
The two possible complications which are linked with the case study of Mr. Hemsley
such as he is having sedentary life style that resulted in the increase in 20 kgs weight such as
107 Kg is his current weight and he an occasional cigarette smoking on the weekends. The
possible care nursing interventions of the priority when effectively managing Mr. Hensley’s
colostomy during the first 24 to 48 hrs post operatively like right after the procedure, it can
seem that a patient have a lot of gas almost every time. In this, many of the surgeries is
generally followed by an uncomfortable, embarrassing symptoms. There are various food
elements which can cause gas such as cabbage, onions, eggs and many more must be avoided
by the patient. The care nursing interventions can include assess to the oral intake by
effectively monitoring their fluid balance on a fluid balance chart to simply determine the
patient’s input as well as the output. Auscultate the abdomen for the bowel sounds, if the
bowel sounds are present, or the patient they are passing flatus, a clear fluid can effectively
commence as well as aperients can be effectively administered. The patient must not
commence the oral fluids if the bowel noises are not present as these such findings can depict
an ileus. In addition to this, the care nurses must provide a proper diet plan chart for Mr.
Hemsley so that he can able to reduce his gained weight more efficiently. The care nurses
must guide the patient in consuming the food such as consume food like meat having visible
fat, skinless poultry, fish and many other. Providing with knowledge about eating less
saturated fats, the processed foods, and enhancing the consumption of fruits and vegetable in
his diet plan (Kim et. al., 2021).

REFERENCES
Books and Journals:
Alenezi, A., McGrath, I., Kimpton, A. and Livesay, K., 2021. Quality of life among ostomy
patients: A narrative literature review. Journal of Clinical Nursing, 30(21-22), pp.3111-3123.
Burch, J., 2021. Stoma-related considerations in palliative patients. British Journal of
Community Nursing, 26(10), pp.494-497.
Gün, E., Kendirli, T., Botan, E., Özdemir, H., Çiftçi, E., Konca, K., Kologlu, M., Göllü, G.,
Can, Ö.S., Tutar, E. and Akar, A.R., 2021. Temporary diverting end-colostomy in critically
ill children with severe perianal wound infection. Advances in Skin & Wound Care, 34(6),
pp.322-326.
Jernigan, C., Johnson, T., Varghese, S. and Fellman, B., 2020, March. Evaluating the
Feasibility of a Nurse-Driven Telephone Triage Intervention for Patients With Cancer in the
Ambulatory Setting. In Oncology Nursing Forum (Vol. 47, No. 2).
Kim, Y.M., Jang, H.J. and Lee, Y.J., 2021. The effectiveness of preoperative stoma site
marking on patient outcomes: A systematic review and meta‐analysis. Journal of Advanced
Nursing, 77(11), pp.4332-4346.
Rivet, E.B., 2019. Ostomy management: a model of interdisciplinary care. Surgical
Clinics, 99(5), pp.885-898.
Online:
Determining the Use of Nonpharmacologic Methods by Surgical Nurses for Postoperative
Pain Management and the Influencing Professional Factors, 2019 [Online] Available
through: < file:///C:/Users/Acer/AppData/Local/Temp/Rar$DIa13976.7840/READING
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%20Postoperative%20Pain%20Management%20and%20the%20Influencing%20Professional
%20Factors.pdf>
Patient-Related Factors Associated With Stoma and Peristomal Complications Following
Fecal Ostomy Surgery, 2021 [Online] Available through:
file:///C:/Users/Acer/AppData/Local/Temp/Rar$DIa13976.9760/READING%20SHORT
%20ANSWER%20ASSESSMENT%20Patient-Related%20Factors%20Associated%20With
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%20Surgery_A%20Scoping%20Review.pdf
Role of the nurse in supporting the safe use of opioids, 2020 [Online] Available through:
file:///C:/Users/Acer/AppData/Local/Temp/Rar$DIa13976.10212/READING%20SHORT
%20ANSWER%20ASSESSMENT%20Role%20of%20the%20nurse%20in%20supporting
%20the%20safe%20use%20of%20opioids.pdf