Sometimes, studies show that elderly patients are perceived not to be in pain because they do not complain about pain, or that the perceive it differently than younger people. In both receptive and non-receptive patients, one can observe facial tics and/or grimaces, blood pressure (elevated blood pressure sometimes indicates more pain), body temperature, and even mobility.
For the functional patient, assessment can be done by observation of body movement, gait, grimacing, and asking the patient to rate pain on a scale and describe the characteristics (burning, stabbing, aching, frequency, duration, etc.). If the patient is cognitively impaired, simple questions can be asked -- "do you feel a burning sensation, etc." If the patient is non-responsive or cannot understand, one can observe changes in behavior, agitation, facial expressions, or vocalizations. Note, too, that cognitively impaired patients can sometimes be overstimulated by their environment, so take that into account. Finally, involve family or caregivers and ask questions. Additionally, particularly for the elderly, pain assessment must be regular since many think that pain is a normal part of aging or are reluctant to report symptoms (Victor, 2001).
1. Assuming we are given the order to administer 500mg acetaminophen orally or .05 mg/kg IV or .1mg/kg IM of morphine to the patient. To properly assess whether any of the pain medications were successful would depend on the patient's condition, the medication given, and the timing. The oral dose of acetaminophen would likely not react for 30-60 minutes, the morphine far quicker. I would regularly monitor the patient's heart rate, blood pressure, and respiratory rate. I would compare these, likely at the 15, 30 and 60 minute interval after injection with pre-medication and actively look for signs showing decreasing...
After administration of the morphine, patient should be calmer, show fewer signs of distress, and potentially be asleep.
2. Assessing the geriatric patient is unlike assessing other ages because it must take into account a more multi-layered approach. One must use advocacy and care theory to assess not only the physical symptoms, but the mental and emotional state of the patient as well as cognitive functions. In elderly patients who are aware and cogent, this is not as difficult; but becomes increasingly so if the patient is cognitively unaware or otherwise unable to speak or understand basic health related questions. It takes a more patient and calm demeanor to work with geriatric patients -- many are anxious and fearful and do not understand; sometimes it is more difficult to draw blood and requires extra care, and at times it is difficult to focus on the relevant past issues and/or uncover the current situation. The key, I believe, is to utilize a more comprehensive approach combined with a thoughtful and caring tone in as relaxed an atmosphere as possible (Tufts University, 2010).
3. Collaborative team members -- included Emergency Room staff (nurses, technicians, physicians), respiratory specialists' as needed, x-ray personnel, phlebotomist, laboratory personnel moving into the patient's own doctor and/or nursing facility staff.
Brown, J. (2009, June). Everything You Need to Know About Hip Injuries. Retrieved from Corepeformance.com:: http://www.coreperformance.com / knowledge/injury-pain/hip-injuries.html
National Institute of Mental Health. (2011, March). Medications for Anxiety, Panic and Phobias. Retrieved from Psychcentral.com: http://psychcentral.com/lib/2006/medications-for-anxiety-panic-and-phobias/
Peck, P. (2003, February). Stroke Tests. Retrieved from WebMD: http://www.webmd.com/stroke/news/20030213/got-minute-you-could-diagnose-stroke
PubMed Health. (2012, September 15). Lisinopril. Retrieved from U.S. National Libary of Medicine: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000917/
Tufts University. (2010, June). Comprehensive Geriatric Assessment. Retrieved from OCW.TUFTS.EDU: http://ocw.tufts.edu/data/42/499797.pdf
Victor, K. (2001, May). Properly Assessing Pain in the Elderly. Retrieved from Modern Medicine: http://www.modernmedicine.com/modernmedicine/article/articleDetail.jsp?id=127583
CUBAN CASE STUDY Mrs. Demetilla Hernandez a 63-year- Cuban woman seeks consultation Liberty health-maintenance organization (HMO) clinic weakness, lethargy, fatigue experienced 2 months. A week ago, cooking dinner daughter, Mariana's house, momentarily lost balance slipped kitchen floor. CUBAN CASE STUDY As a health-care provider, what are the typical Cuban communication patterns you need to be aware of in dealing with Mrs. Hernandez? Latino families are often multigenerational in their composition. As the grandmother,
Lingu francas are languages used b wide groups of people to facilitate communication between cultures that traditionally use separate languages; English is the lingua franca of much of the world, as people from Sweden to China to Egypt learn it to facilitate international communication. Pidgins and creoles are bastardizations of two or more languages from a merging or meeting of cultures. National and official languages can be established to ease
Recruitment of a Star In the case study presented by Groysberg et al. (2007), Stephen Conner has a number of difficulties to face in his hiring decision. The unexpected departure of his star semiconductor analyst -- at a particularly crucial juncture for Conner's firm, handling a semiconductor-related deal -- means that Conner needs to make a replacement decision fast. But how does a firm replace a star? Each of Conner's potential
In the last few decades the percentage of women in the labor force has dramatically increased from 11% in 1940 to 56% in 1980 with 62% of the women between the ages of 45 and 65 employed (U.S. Department of Labor, 1986).The extent to which such employment affects caregivers is apparent in the results of a survey conducted by the AARP. Findings reveal that 55% of the women caring
Mama Might Be Better off Dead For the past several decades, health care reform has been on the top of the political lip service agenda. Presidential candidates debate heatedly over which types of Medicare or Medicaid reforms should be instated and purport to want "universal health care." They call out for assistance to low-income families and claim that no American citizen should go without health care services. Yet through all
Bend it Like Beckham -- An Analysis Through Gender-Lens Women's role lies at the heart of a number of cultural norms, forming a salient aspect of their survival. The football-themed movie, "Bend It Like Beckham" portrays an Indian girl, Jesminder "Jess" Bhamra struggling over her passion for football with her mom and other family members. She meets Jules (or Juliette Paxton), who invites Jess to become a part of the Hounslow