Sunday, December 8, 2019

Reflection Interview for Domains and Mechanisms-myassignmenthelp

Question: Discuss about theReflection Interviewfor Domains, Methods and Mechanisms. Answer: Reflection Interview Reporting Responding My training has prepared me for my nursing career asit has equipped me with knowledge and skills that I will apply during my practice. For instance, I was once presented with a 27-year old male patient complaining of pain after a total hip replacement surgery. Before applying any pain management techniques, I felt it was important to first assess the severity of the pain in order to determine the best intervention method. I used a numerical rating scale and the patient scored a 5, on a scale of 1 to 10. During the assessment, I felt that it was also important to ask the patient how bad the pain was to avoid recording a score that was way above or below his own assessment. He told me that it was getting worse and he was afraid he wouldnt bear it for long. I also asked him where exactly he was feeling the pain and for how long this had been going on. The patient informed me that it had been going on for about one hour and the pain was around the hip joint. This provided information on how best to monitor the effectiveness of my interventions. Relating To manage the pain, I repositioned the patient ensuring that I did not apply any undue tension on the new prosthesis and the surrounding tissues (Garson, Schwarxkopf, Vakharia, Alexander, Stead, CannessonKain, 2014).This is because, maintaining an appropriate position of the operated extremity helps in reducing any muscle spasm (Stang, Hartling, Fera, Johnson Ali, 2014). I also encouraged the patient to engage in stress management techniques and diversional activities such as progressive relaxation, visualization, meditation and imagery. From my personal experience, I figured that this would help in refocusing his attention from the pain and he will be in a better position to manage or cope with any discomfort or pain for a while. Reasoning Additionally, I administered some muscle relaxants and opioid analgesics in the form of morphine to help manage the pain and improve the patients comfort. Opioid analgesics pose certain side effects such as reduced gastrointestinal mobility, nausea and respiratory depression (Garson, Schwarxkopf, Vakharia, Alexander, Stead, CannessonKain, 2014). As a result, I frequently reassessed his respiratory rate, nausea and bowel movement. Further, the early detection of a developing problem such as a dislocation of the prosthesis gives one an opportunity to promptly intervene and prevent any more adverse complications (Joshi, SchugKehlet, 2014).From this, I asked the patient if he was experiencing any sudden severe joint pains and muscle spasms or any changes in joint motility and fortunately, his response was negative. Had the patient experienced any of this, I would have administered an anti-emetic drug to counter the sickness. After a short while, the patient reported that the pain was sub siding and he also appeared a bit more relaxed and capable of sleeping. Reconstructing From my own point of view, I feel that this situation presented me with a platform to show how best I can carry out pain assessment and management. This situation taught me the importance of pain assessment before any intervention methods as it helps in making a well-informed decision. I also learnt that it is important to engage the patient and ask questions pertaining to the severity, location and duration of the pain before taking any measures. A study done by Coll, Ameen and Mead, (2014) revealed that often, nurses record a patients pain score that is lower than the patients personal assessment. Therefore, it is important to always listen and consider whatever the patient is saying (Fillingim,Loeser, Baron Edwards, 2016). Despite the fact that I did not apply all pain management techniques, I learnt that using some of the methods helps in relieving pain. In my intervention, I left out methods such as applying ice to the affected area which could have helped to promote vasoconstriction and reduce any perception of discomfort. As a result, in future, I will consider all pain management techniques and their benefits and apply those that are most appropriate for my patient, this is essential in ensuring patient safety and quality of care. A combined approach is usually the best option as it allows one to tailor pain management methods that are suitable to each individual (Jensen Karoly, 2013).To sum up, this situation has taught me that professional healthcare practice requires calculated and combined intervention methods to relieve pain from a patient. In this case, I have learnt that my training has sufficiently prepared me for my nursing practice and my future practice as a nurse as I was able to carry out successful pain assessment and management for the patient. Lastly, I need to use a combination of all relevant approaches that are suitable for my patients condition in future. References Coll, A. M., Ameen, J. R., Mead, D. (2014). Postoperative assessment tools in day surgery: literature review. Journal of advanced nursing, 46(2), 124-133. Fillingim, R. B., Loeser, J. D., Baron, R., Edwards, R.R. (2016). Assessment of chronic and acute pain: Domains, methods, and mechanisms. The Journal of Pain, 17(9), T10-T20. Garson, L., Schwarxkopf, R., Vakharia, S., Alexander, B., Stead, S., Cannesson, M., Kain, Z. (2014). Implementation of a total joint replacement-focused perioperative surgical home: a management case report. Anesthesia and Analgesia, 118(5), 1081-1089. Jensen, M. P., Karoly, P. (2013). Self-report scales and procedures for assessing pain in adults. Joshi, G. P., Schug, S. A., Kehlet, H. (2014). Procedure-specific pain management and outcome strategies. Best Practice Research Clinical Anesthesiology, 28(2), 191-201. Stang, A. S., Hartling, L., Fera, C., Johnson, D., Ali, S. (2014). Quality indicators for the assessment and management of pain in the emergency department: a systematic review. Pain Research and Management, 19(6), e179-e190.

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