NUR2447 Clinical Concepts: Pain Management Case Study Answers 2020

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NUR2447 Pain Case Study

Assessment Details:

• Topic: Case study
• Subject: Medical & Nursing·
• Deadline:*: As Per Required
• Number of Words: 1500
• Citation/Referencing Style: APA 7th

 

Background information Jane is being assessed for her pain at her first visit to the pain clinic. Jane is a 41-year-old enrolled nurse who presents with constant deep and achy back pain. She states that she has had the back pain for several years and it is getting progressively worse. Jane was involved in a car accident on her way home from work four (4) years ago, which resulted in a soft tissue injury to her spine and a whiplash injury to her neck.

Jane is married with two children, 6 and 9 years old. She had been an active, healthy individual prior to the accident; however, she is now finding that the pain is interfering with her ability to work and undertake her normal activities with her family. History and assessment are as follows:

Medical Jane’s care has been managed by her GP for the past four (4) years using NSAIDs, muscle relaxants, physical therapy and home exercises. Over the last year, the pain has become progressively worse, to the point where this treatment is no longer effective. Nil other relevant history: previously fit and healthy. Jane underwent cortisone injections into the facets of her spine 6 months ago, but she is reluctant to undergo the therapy again due to the fact that she experienced minimal relief following the procedure.

Medications (as per table) Ibuprofen

Paracetamol APO-

Baclofen Tramadol SR Capsaicin cream

Assessment Jane is alert and oriented, and answers questions appropriately. Skin: pale, with slight perspiration evident. Mobility: trunk movements are restricted, and Jane demonstrates obvious distress on movement.

Jane complains of a constant dull ache in her lumbar spine, which she says has been getting progressively worse and has become continuous over the last 12 months. Jane states that this pain is never less than 2 out of 10, even after medication. At least four times a week Jane experiences back spasms, during which the pain becomes severe, up to 7/10.

Jane has been finding that the pain is affecting her quality of life, with restrictions on her ability to care for, and play with, her children. When asked about her mood, Jane explains that the constant pain causes mood fluctuations from day to day. These range from depression to anger, and she is often frustrated by her physical limitations. The mood swings impact on her relationship with her partner and children. Jane states

1 Student Number: That she is increasingly unable to concentrate on activities, as she ‘gets lost trying to do things’.

NUR Pain Case Study

Section 1:

Part A: Assessment

Discuss your assessment of Jane’s pain

Include:

• The initial general questions you would ask about her pain and observations about her behaviours.
• Discuss five (5) different relevant assessment tools you might utilise to assess the various elements, and which reflect the impact of the pain for Jane.
• Include your rationales for the assessment undertaken and the tools chosen.
• You need to include references to support your discussion

Part B: Type of Pain

• What type/s of pain is Jane experiencing? Provide rationales for your

• Discuss the physical and psychosocial factors that you might expect to impact on Jane’s experience of pain and the way she has responded/changed due to her pain, providing rationales.

• You need to include references to support your discussion

 

Section 2:

Part A: Management Plan

Outline, and discuss in-depth, a plan of care that addresses Jane’s pain management.

• Your plan must reflect a patient-centred approach (physical and psychosocial) to promote optimal outcomes
• Include
  • Non-pharmacological therapies (nursing and complementary)
  • Education o other practitioners who may be/need to be involved in her care
  • Physical and psychosocial supports that may be required

• Do not include medications in this section.
• You need to include references to support your discussion

Part B: Medications

Complete the table of medications that Jane is currently prescribed. You need to provide detailed information about:

• The mode of action (how it works to relieve pain).
• Rationales for their use (why it would be used for Jane/what type of pain is it effective for?).
• You need to include references to support your discussion.

 

NUR Pain Case Study

Medication

1. Mode of action
2. Rationale for use (How does it work to relieve (Why is it being used for Jane: pain)

what type of pain is it effective for?) Tramadol SR 200mg oral morning and night

APO- Baclofen 20 mg oral TDS.

Capsaicin cream Topical 3 x daily (tds)
Ibuprofen 400 mg Oral 6/24 PRN (whenever necessary)

Paracetamol 1gm Oral 4-6/24 PRN (whenever necessary)

Assessment Task 2, Pain Assignment – Marking Rubric

S ection 1: Part AApprox. (300 words)P ain Assessment	Comprehensive knowledge of pain assessment demonstrated.
1 5 marks
	Detailed discussion of
Assessment questions and	assessment questions and
behaviours identified	tools.
Pain assessment tools
chosen and reasons for	Discussion well supported by
choice discussed	relevant, current, and credible
	sources.
Rationale for assessment
processes and tools
chosen provided
Use of current and
relevant literature to
support discussion.
/15 marks
S ection 1:Part BApprox. (275 words)P ain type, Physiological	Pain type/s comprehensively identified and discussed Comprehensive knowledge of
c hanges	physical and psychosocial
1 5 marks	factors. Detailed rationale
	provided.
Identify pain type/s and
provide rationale for	Well supported by relevant,
choice/s.	current, and credible sources.
Physical and psychosocial factors that may have, or	12-15
have had, an impact on
experience of pain
Rationale for choices
provided
Use of current and
relevant literature to
support discussion.

 

/15 marks
S ection 2: Part A	Plan of care addresses all patient management requirements.Comprehensive list of supportsidentified and their use discussed in depth Relevant practitioners identified, reasons for their involvement discussed in detail and link to the scenario made evident Non-pharmacological therapies discussed in significant detail Detailed discussion of education needs Well supported by relevant, current, and credible sources 32-40
Approx. (750 words)
M anagement plan 40 marks
– Discuss the factors related
to the management plan
required for the patient
and her pain
– Physical and psychosocial
supports that could assist
the patient (15)
– Other practitioners to
involve in her care(15)
– Non-pharmacological
therapies (10)
– Education needed
– Use of current and
relevant literature to
support discussion.
–
/40 marks
M edications	Comprehensive discussion ofmode of action Detailed rationale for choice of medication is provided and clearly linked to scenario   Well supported by relevant, current, and credible sources 8-10
Approx. (200 words)
– Mode of action
– Rationale for their use
– Use of current and
relevant literature to
support discussion.
– Use of current and
relevant literature to
support discussion?
/10 marks
P resentation	Shows a polished and
Submission presented	An imaginative approach to
according to guidelines	the
Use appropriate academic	topic.
tone, grammar, spelling

 

and punctuation. / 10 marks	Fluent writing style appropriate to the assignment. Academic tone sophisticated, clear, precise and consistent.   Language fluent. Grammar and spelling accurate.   Complies with submission guidelines. 8-10
R eferencingCitations and reference list cited according to APA 7th ed. Formatting.Use of current, credible, relevant and reliable literature demonstrating wide reading to support arguments. (min 10 references).	Mastery of referencing usingAPA 7th style evident.  Critical assessment and application of readings relevant to the subject   Ideas well developed and based on a wide range of relevant contemporary sources.
/ 10 marks
	Clearly able to synthesise topics.
	8-10

 

NUR2447 Pain Case Study: You have been asked to use the headings provided in the instructions, here is a possible structure for the case study that you can adapt to suit your own writing. Think about using headings that summarise the content of your response to the task. Some alternative headings are also provided below.

SECTION 1:Part A: Assessment	Alternatives – below are a few suggestions Think about other headings you may wish to add or change
General Questions•  heading for each type of question & write the questions you will ask the patient	Observations about Behaviour
Assessment Tools•  title = name of toolParagraph . . . .	Observational Behaviour
•  title = name of toolParagraph . . . .
•  title = name of toolParagraph . . . .
•  title = name of toolParagraph . . . .
•  title = name of toolParagraph . . . .
Part B: Type of Pain
Type/s of pain
Paragraph . . . .
Physical and physiological factors
Paragraph . . . .
SECTION 2:Part A: Management Plan	SECTION 2
Non-pharmacological therapiesParagraph/s . . . .	Alternatives:
EducationParagraph . . . .	Could use 2 main headings &subheadingsPhysical
Other practitionersParagraph/s . . . .	Psychosocial
	****************************
Physical and psychosocial supportsParagraph/s . . . .	Could use name of therapy as title
Part B: Medications	Could use name of practitioner as title
Complete the table of medications

 

Medication	1. Mode of action(How does it work to relieve pain)	2. Rationale for use(Why is Jane having this medication? Why isthis medication used for Jane? What type of pain is it effective for?)
Tramadol SR 200mg oral morning and night	Sentences orintext citations	Sentences orintext citations

 

SECTION 1:

Part A: Assessment

Paragraph . . .

General Questions

 

Assessment Tools

• Title of tool

Paragraph . . . .

• Title of tool

Paragraph . . . .

• Title of tool

Paragraph . . . .

• Title of tool

Paragraph . . . .

• Title of tool

Paragraph . . . .

 

Part B: Type of Pain

Type/s of pain.

Physical and physiological factors

SECTION 2:

Part A: Management Plan

Outline a plan of care that addresses Harry’s pain management.

• Your plan must reflect a patient centred approach (physical and psychosocial) to promote optimal outcomes
• Include
  • non-pharmacological therapies (nursing and complementary)
  • education
  • other practitioners who may be/need to be involved in his care
  • physical and psychosocial supports that may be required

Do not include medications in this section.

Part B: Medications

Complete the table of medications prescribed for Harry. You need to provide detailed information about:

• The mode of action (how it works to relieve pain)
• Rationales for use (why it would be used for Harry/what type of pain is it effective for)

 

2019 Version

Medication	3. Mode of action(How does it work to relieve pain)	4. Rationale for use(Why is Jane having this medication? Why isthis medication used for Jane? What type of pain is it effective for?)
Tramadol SR 200mg oral morning and night	Sentences or •intext citations	Sentences or •intext citations
Gabapentin 600mg Oral 8/24
Capsaicin cream Topical3 x daily (tds)
Ibuprofen 400 mg Oral 6/24prn (whenever necessary)
Paracetamol 1gm Oral4/24prn (whenever necessary)

 

 

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