University Assignment: Patient Education on Tramadol for Post-Op Care

This assignment presents a patient education plan for Mrs. Caroline Morris, a 47-year-old woman post-bowel resection and ileostomy, focusing on Tramadol 50 mg qid, prescribed for moderate to severe post-operative pain. The plan emphasizes effective communication, addressing the patient's con...Read More

Running head: PATIENT EDUCATION TRAMADOL
PATIENT EDUCATION TRAMADOL
Name of the Student:
Name of the University:
Authors note:

1PATIENT EDUCATION TRAMADOL
Patient Context:
Mrs Caroline Morris, is a 47 year old women who is divorced and has a past history of
ulcerative colitis of past 30 years (since her teen age years). Mrs Morris has gone through
bowel resection and ileostomy she on her 5th day post-operative treatment ready to be
discharged. She had good job in the field of Information Technology which was hindered due
to her health condition. However, she wishes to return to her IT employment in the future.
Her daughter Shannon is going stay for the next four weeks, and she will also receive
community nursing service.
Cues collected from Scenario:
Mrs Morris is:
 Currently refusing to drink water as she is afraid that she will increase the output of
the bag.
 Reluctant to use the Pain Controlled Analgesic (PCA).
 Her pain level 8 out of 10.
 Not wanting to take any other medication
Medication
Tramadol 50 mg qid, used under the commercial name ULTRAM, is a centrally acting
synthetic opioid analgesic, which is a Mono oxidase inhibitor, it is given in case of moderate
to severe pain. It acts by activating μ-opioid receptor and inhibiting the neurotransmitter
reuptake (Gong et al. 2014). It is preferably used for acute pain management and as a post-
operative medication in older adults (Falzone, Hoffmann and Keita, 2013).
Script Justification

2PATIENT EDUCATION TRAMADOL
Good morning, Mrs Morris, How are you
feeling today? I am a Registered Nurse here.
The pharmacy has sent you medication about
which I need to talk to you before you go home
today.
Effective communication is an essential part of the
nursing practice. According to Kourkouta and
Papathanasiou (2014), frankness between the patient
and nurses is an important step, when the patient is
approaching towards self-management.
I am experiencing a stabbing sharp pain, and
my pelvis, abdomen and back hurts a lot.
Patient shares her concerns about the pain she is
facing, which is important especially in a post-
operative scenario.
Mrs Morris, have you been using PCA?
As your pain level 8/10, which is very severe.
It is important for me to know that whether the PCA
is effective in this case or not.
No, I have a feeling that it may cause me to
stop breathing and make me feel nauseated.
According to Patak et al. 2013, there can be series of
negative reviews and experiences when it comes to
the use of PCA, which is fear of overdose and
addiction.
Mrs Morris, I have a medication for you, which
will relieve your pain. Would it be okay for you
if I sit down, and discuss about your medicines.
It will only take few minutes. And you can ask
question you have on your mind during our
conversation.
At this point I develop my conversation with Mrs
Morris, by sitting down maintaining an eye contact
with her and I assure her that her pain will be
relieved. According to King and Hoppe (2013), it is
important for the healthcare professional to engage
the patient in the conversation as well as
understanding their language.
Okay sure! I want to get relief of this pain and
want go back to my work as soon as possible.
By this point it is understood that she wants to get
relief of her pain and I can proceed with the patient
education, and since her daughter Shannon is along

3PATIENT EDUCATION TRAMADOL
with her, I make her understand the medication
regime as well.
Very well then! Your medication, is Tramadol
50 mg, qid. , is an opioid which is used to
decrease the pain that you are having, and it has
to be taken by mouth four times a day along
with meals. Intake of alcohol should be
avoided.
It has to be taken in a gap of 4 hours. The side
effects include nausea, diarrhoea, and
headache. However, try to lie to down with
reduced head movement, in case of nausea.
Drink a lot fluids to avoid constipation.
Explaining the medication regime along with the side
effects is an important part of my patient education
and treatment plan. It is important to maintain
informed consent, while explaining the post-operative
pain management (Sugai et al. 2013).
Ok, When will I able to do daily household
work and chores? Drinking water can increase
the bag and I am worried about it.
The teach-back method has been developed, this will
ensures that the patient is attentive as well as
understanding the medication regime (Peter et al.
2015)
Good question! Mrs Morris, you will have to
avoid heavy objects that would include
vacuuming the house for 2 to 3 months. The
community nurse and stomal therapy nurse will
be visiting you at your home and she will be
guiding you further with your output bag. So
do not worry and do drink. Ok?
Will I able to re-join my job again?

4PATIENT EDUCATION TRAMADOL

5PATIENT EDUCATION TRAMADOL
Yes Of course, Mrs Morris, you can do redeem
your normal life, as soon as you feel
comfortable to work and doctor approves you. I
have further printed out detailed medication, so
that you can refer to it whenever you need.
At this point I observe that she has overcome the
stress she was having. Addressing psychological as
well as physical is an important part of patient
education (Danielsen, Burcharth and Rosenberg
2013).

6PATIENT EDUCATION TRAMADOL
References
Danielsen, A.K., Burcharth, J. and Rosenberg, J., 2013. Patient education has a positive effect
in patients with a stoma: a systematic review. Colorectal Disease, 15(6), pp.e276-e283.
Falzone, E., Hoffmann, C. and Keita, H., 2013. Postoperative analgesia in elderly
patients. Drugs & aging, 30(2), pp.81-90.
Gong, L., Stamer, U.M., Tzvetkov, M.V., Altman, R.B. and Klein, T.E., 2014. PharmGKB
summary: tramadol pathway. Pharmacogenetics and genomics, 24(7), p.374.
King, A. and Hoppe, R.B., 2013. “Best practice” for patient-centered communication: a
narrative review. Journal of graduate medical education, 5(3), pp.385-393.
Kourkouta, L. and Papathanasiou, I.V., 2014. Communication in nursing practice. Materia
socio-medica, 26(1), p.65.
Patak, L.S., Tait, A.R., Mirafzali, L., Morris, M., Dasgupta, S. and Brummett, C.M., 2013.
Patient perspectives of patient-controlled analgesia (PCA) and methods for improving pain
control and patient satisfaction.
Peter, D., Robinson, P., Jordan, M., Lawrence, S., Casey, K. and Salas-Lopez, D., 2015.
Reducing readmissions using teach-back: enhancing patient and family education. Journal of
Nursing Administration, 45(1), pp.35-42.
Sugai, D.Y., Deptula, P.L., Parsa, A.A. and Parsa, F.D., 2013. The importance of
communication in the management of postoperative pain. Hawai'i journal of medicine &
public health, 72(6), p.180.