Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Oct 2005
Effects of preoperative teaching of the use of a pain scale with patients in the PACU.
Clinical observations have shown that patients arriving in the PACU who had no experience using a pain scale had more difficulty rating their pain in the immediate postoperative period. The purpose of this pilot study was to determine if preoperative instruction on the use of a pain scale would improve the patient's ability to self-report pain in the Phase I PACU. The sample consisted of 50 English speaking, orthopedic patients between the ages of 19 and 75 years. ⋯ Of the 24 patients who were taught in the holding area, 20 (85%) could use the pain scale to rate their pain in the PACU. The results of this study suggest that if patients have previous experience with a pain scale, or if they are taught preoperatively, they can more effectively self-report pain postoperatively. Future studies should be conducted to involve a larger sample, a variety of surgeries, and non-English-speaking patients.
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J. Perianesth. Nurs. · Aug 2005
ReviewPatient-controlled modalities for acute postoperative pain management.
Although numerous clinical practice guidelines for pain management have been published throughout the last 12 years, inadequate pain relief remains a significant health care issue. Several patient-controlled analgesia (PCA) modalities are currently available for the treatment of acute postoperative pain, including intravenous (IV) PCA, epidural (PCEA), and oral PCA. ⋯ Consequently, noninvasive PCA systems are under development to circumvent many of these limitations, including the fentanyl hydrochloride patient-controlled transdermal system (PCTS); (IONSYS Ortho-McNeil Pharmaceutical, Raritan, NJ) and a number of patient-controlled intranasal analgesia (PCINA) delivery systems. The objective of this article is to review the PCA modalities currently in use and to discuss those in development for the treatment of acute postoperative pain.
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Domestic abuse is a devastating social, legal, and health care problem of enormous proportions. Routine and multiple screenings by skilled health care providers, when conducted face-to-face, markedly increase the identification of physical, psychological, and sexual abuse. Patients are not the only ones who can benefit from domestic violence screening and intervention. This article describes the subtle signs of domestic abuse that might be observed in a colleague, explains how to initiate a conversation with a colleague, and suggests appropriate ways to offer support.
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J. Perianesth. Nurs. · Aug 2005
Nurses' diagnoses and treatment decisions regarding care of the agitated child.
Postoperative agitation has many potential etiologies and remains a significant clinical issue in the pediatric PACU setting. Caring for the agitated child requires a thorough assessment and calls for targeted interventions. This observational study evaluated nurses' diagnoses and treatment decisions regarding care of the agitated child. ⋯ Physiologic abnormalities were identified as the source for agitation in only 3 cases, but went unrecognized for an extended period in 2 children. Results of this study underscore the complexity of assessment and treatment decisions when caring for agitated children. A decision algorithm based on this study is described as a potential aid toward differentiation of agitation and appropriate intervention.