Nursing Care, Delirium, and Pain Management for the Hospitalized Older Adult

2010 ◽  
Vol 11 (3) ◽  
pp. 177-185 ◽  
Author(s):  
Ann M. Schreier
2020 ◽  
Vol 35 (10) ◽  
pp. 436-438
Author(s):  
Edgar Garcia ◽  
Justin P. Reinert ◽  
Michael Veronin

While opioids have historically been the initial choice of analgesic for both acute and chronic pain, legislative and deprescribing trends as a result of the opioid epidemic have demonstrated an increase in the use of adjunctive therapies. These adjunctive agents are being utilized with increased frequency, especially in older adult patients, as a mechanism to mitigate any likelihood of dependency and in an effort to provide multimodal pain management. As this patient population can be more challenging because of comorbidities, the presence of polypharmacy, pharmacokinetic, and pharmacodynamic changes, it is important to evaluate the risk of any relevant adverse effects for opioids and adjuncts that can lead to higher risk of opioid toxicities. Gabapentin is one of the most commonly added adjunctive medications; however, its safety and efficacy in conjunction with opioids has not been exclusively considered in older adult patients in the perioperative setting. This report will summarize available evidence for gabapentin as an adjunctive therapy to opioids in older adult patients undergoing surgery.


1982 ◽  
Vol 82 (5) ◽  
pp. 872
Author(s):  
Shirlee Ann Stokes ◽  
Mildred O. Hogstel

2014 ◽  
Vol 32 (1) ◽  
pp. 41-62 ◽  
Author(s):  
Jennifer J. Hatzfeld ◽  
Susan Dukes ◽  
Elizabeth Bridges

The en route care environment is dynamic and requires constant innovation to ensure appropriate nursing care for combat casualties. Building on experiences in Iraq and Afghanistan, there have been tremendous innovations in the process of transporting patients, including the movement of patients with spinal injuries. Advances have also been made in pain management and noninvasive monitoring, particularly for trauma and surgical patients requiring close monitoring of their hemodynamic and perfusion status. In addition to institutionalizing these innovations, future efforts are needed to eliminate secondary insults to patients with traumatic brain injuries and technologies to provide closed-loop sedation and ventilation.


2012 ◽  
Vol 16 (4) ◽  
pp. 177-194 ◽  
Author(s):  
Ann Butler Maher ◽  
Anita J Meehan ◽  
Karen Hertz ◽  
Ami Hommel ◽  
Valerie MacDonald ◽  
...  

2009 ◽  
Vol 66 (2) ◽  
pp. 156-162 ◽  
Author(s):  
Dragana Milutinovic ◽  
Verica Milovanovic ◽  
Miroslava Pjevic ◽  
Mirjana Martinov-Cvejin ◽  
Tomislav Cigic

Background/Aim. Managing of acute postoperative pain should be of great interest for all hospital institutions, as one of the key components of patients satisfaction, which indicates quality, as well as the outcome of treatment. The aim of this study was to assess the quality of nursing care in managing acute postoperative pain and to establish factors which influence patients assessment of the same. Method. The investigation was conducted on the sample of 135 patients hospitalized in surgical clinics of the Clinical Centre of Vojvodina in Novi Sad in the form of cross-sectional study, by interviewing patients during the second postoperative day and collecting sociodemographic variables, type of surgical procedure and applied analgesic therapy which were taken from their medical documentation. The modified questionnaire of the Strategic and Clinical Quality Indicators in Postoperative Pain Management (SCQIPP) was used as the instrument of the investigation. The data were processed with suitable mathematical statistics methods such as multivariate analyses of variance (MANOVA), discriminative and other parametric procedures and methods. Roy's test, Pearson's coefficient contingency (?), multiple correlation coefficient (R) were conducted amongst other invariant procedures. Results. The mean score for the individual items of SCQIPP questionnaire was between 2.0 and 4.7 (scale range 1-5) and the percentage of patients answers 'strongly agree' ranged from 4.4 to 77%. The smallest number of positive answers were given by the patients for the item 'In order to assess pain intensity, some of the staff asked me at least once in the morning, in the afternoon and in the evening to show the number from 0-10'. Most of the patients (57%) evaluated severe pain during the previous 24 hours, as moderate pain, which represents significantly greater number of patients which complain of severe pain and mild pain (p < 0.001). The analysis of patients evaluation (MANOVA p < 0.05 and discriminative p < 0.05) indicates the existence of significant difference between the assessment of nursing care quality in managing acute postoperative pain as regards to clinics as the place for pain management, patient's sex and his expectations. Evaluation from 'communication' subscale gives the greatest contribution (24.9%) to the difference between the observed clinics, and the greatest contribution (25.7%) to the difference in evaluation of nursing care quality as regards to patients' sex has the evaluations from 'procedure' subscale. Conclusion. The results of this study show a useful evidence and identify aspects of nursing care in postoperative management of acute pain which are still to be improved. According to the patients' answers the priority should be given to a regular assessment of the intensity of postoperative pain and evaluation of the effects of analgesic therapy.


2019 ◽  
Vol 10 (7) ◽  
pp. 392-396
Author(s):  
Lauren Osborne

A 4-year-old feline was admitted to the veterinary hospital for haemorrhagic pericardial effusion leading to cardiac tamponade of unknown origin. Concurrent subclinical hypertrophic cardiomyopathy (HCM) was also diagnosed. After significant diagnostic tests and reoccurrence of the effusion, the patient underwent a subtotal pericardiectomy. Results were consistent with neutrophillic/granulomatous pericarditis of unknown origin. This article discusses the nursing care implemented postoperatively, focusing on the major themes of pain management, pain scoring, management of the thoracostomy tube and the correction of dehydration and maintaining the patient's nutritional requirements. After 7 days of hospitalisation, the patient recovered well and was discharged.


1990 ◽  
Vol 16 (6) ◽  
pp. 38-38
Author(s):  
Diane L Myers
Keyword(s):  

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