Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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Each year thousands of older adults will suffer trauma injuries. Geriatric patients who sustain serious injuries are at risk for increased morbidity and mortality. Preexisting medical conditions can dramatically impact every aspect of care in older patients. ⋯ However, compensatory mechanisms in older individuals may not be predictable in response to physiological needs. Perianesthesia nurses caring for older trauma patients should be familiar with the anatomical and physiological changes of aging, and have an awareness of the original mechanism of injury, coupled with the surgical procedure and anesthesia agents. Astute nursing assessments using critical thinking skills, together with effective nursing interventions, provide the framework for understanding and managing geriatric trauma patients in the perianesthesia care continuum.
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The perianesthesia nurse is continually challenged to provide safe and effective pain management. This task becomes more difficult when working with an aging population. ⋯ To provide quality pain care for geriatric patients, who are at greater risk for developing potentially life-threatening side effects of commonly used analgesics, the perianesthesia nurse must be knowledgeable about factors that affect pain management in this population. Common factors affecting pain control in the older adult patient include misconceptions regarding use and effects of analgesics, preexisting cognitive impairment, impaired communication, cultural differences between the nurse and the patient, and physiologic changes in aging that affect how drugs are metabolized.