This pack of NR 305 Week 2 TD 1 Pain Assessment gives the answers on:
John, a 46-year-old African-American male presents for admission to your hospital for hemi-colectomy for colon polyps. He is complaining of chronic back pain. Patient is on disability from work related injury. History of two (2) previous back surgeries with relief of numbness in RLE but pain has not been relieved. His current medications include Methadone, Neurontin and Norco. John states he takes Benadryl PM every night in addition to his prescribed medications. John is a smoker and smokes 1 PPD. John confides in you that he is considering a spinal cord stimulator for the chronic pain.
What risk factors does John have for risk of opioid withdrawal during this hospitalization?
Is there a stigma connected to being disabled and or methadone?
Does the nurse need to be concerned about acetaminophen use?
What are the differences in acute and chronic pain?
Expert Solution Preview
John has several risk factors for opioid withdrawal during his hospitalization. First, he is taking methadone, which is an opioid medication used to manage chronic pain. Prolonged use of opioids can lead to physical dependence, and sudden discontinuation or a decrease in the dosage of opioids can trigger withdrawal symptoms. Second, John is also taking Norco, which contains hydrocodone, another opioid medication. Combining multiple opioids can increase the risk of withdrawal symptoms. Third, John is a smoker, and smoking has been shown to increase the metabolism of opioids, potentially leading to reduced effectiveness and withdrawal symptoms. Lastly, John confides in considering a spinal cord stimulator for his chronic pain, which suggests that his current pain management regimen may not be entirely effective, increasing the likelihood of withdrawal symptoms during his hospitalization.
There is a stigma connected to both being disabled and taking methadone. People with disabilities often face discrimination and prejudice from society, which can label them as weak or less capable. Similarly, individuals who take methadone may face stigma due to the association of the medication with substance abuse and addiction. This stigma can lead to social isolation, decreased access to healthcare and employment opportunities, and negative perceptions from healthcare providers, which can adversely impact their overall well-being.
The nurse needs to be concerned about acetaminophen use in John. Acetaminophen is a commonly used medication for pain relief, but it can cause liver damage if taken in excessive amounts or in combination with other medications that contain acetaminophen. Since John is already taking multiple medications, including Norco, which already contains acetaminophen, the nurse should be cautious and monitor the total daily dose of acetaminophen to ensure it stays within safe limits and does not pose a risk to John’s liver health.
Acute pain and chronic pain are two distinct types of pain based on their duration and underlying causes. Acute pain is typically temporary and is often associated with an identifiable injury or illness. It serves as a warning sign that something is wrong and helps the body initiate protective and healing mechanisms. Acute pain usually resolves as the underlying cause is treated or heals. On the other hand, chronic pain lasts longer than expected healing time or persists beyond the resolution of the underlying cause. It can be caused by various conditions, such as nerve damage, musculoskeletal disorders, or chronic diseases. Chronic pain often lacks a clear temporal link to an initiating event and can significantly impact a person’s physical and emotional well-being. Managing chronic pain requires a multidisciplinary approach with a focus on long-term pain relief and improved quality of life.