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  • Essay / pain - 1144

    Toby-Finn, a 21-year-old white male, presents to the emergency department with a chief complaint of severe abdominal pain. Toby-Finn, who is a full-time student, was just discharged from the medical-surgical unit three days ago following a laparoscopic appendectomy. Upon arrival at the emergency department, Toby-Finn underwent a CT scan of his abdomen, was diagnosed with ischemic necrosis of the small intestine, and required further abdominal surgery. Toby-Finn received a total of four milligrams of morphine sulfate intravenously, five milligrams of Reglan intravenously, and one liter of normal saline intravenously in the emergency department. The admitting doctor, Dr. Sophie, had contacted the surgeon, Dr. Scarlett, for emergency surgery. In the meantime, Dr. Sophie had provided a written pain management prescription to ensure patient comfort. Nurse Molly, who continues care in the medical-surgical unit, has noted that Toby-Finn and his brother Toto are anxious. She initiated therapeutic communication and encouraged the patient and brother to verbalize their feelings and concerns. Toby-Finn then said he feared the pain would never go away. Nurse Molly is aware that pain is an unpleasant sensory and emotional sensation associated with actual and potential tissue damage (Porth, 2011). To his knowledge, Nurse Molly explained acute and chronic pain. Pain is a complex and subjective phenomenon that involves biological, psychological, social and cultural factors. It is interpreted and perceived in the brain. Each individual reacts differently to pain, because each person has different pain thresholds and tolerances. According to Porth (2009), behavioral therapies, which include the use of guided imagery, have shown promise in changing pain perception and coping patterns in people with chronic illnesses, including pain. Additionally, to ensure patient comfort, pain control promotes recovery and can reduce the risk of developing certain complications after surgery. Through the use of guided imagery and other pain management strategies, patients can better control pain, improve functioning, and experience a better quality of life (Dobson & Byrne, 2014). Additionally, the inability to escape pain can create a feeling of helplessness or even hopelessness, which can predispose the patient to more chronic depression. According to Wells, Pasero, and McCarffery (2008), 24-hour administration is recommended during this early post-surgical period in order to prevent severe pain and control ongoing pain...