This paper critically evaluates the pain management that can be administered to Mrs. Elli Baker, a geriatric patient.
- Managing Pain in a Geriatric Patient Experiencing Multisystem Failure
Pain is a frequent complaint for the elderly generation. The Merck Manual (2011) indicates that as the numbers of older individuals continues to surge, chronic diseases and frailty, which are associated with pains, will also continue to grow. Therefore, the primary care physicians, such as nurses and doctors among others, will face significant challenges in managing pain for this older generation. This is because the older generation often faces multiple multisystem failures, an aspect that further complicates chances of pain management. Birch (2010) argues that there are many different barriers to effective pain management that include the following:
- challenges to effective assessment of the pain;
- underreporting by the patients;
- atypical pain manifestation by the elderly;
- the need to increase appreciation of pharmacodynamic and pharmacokinetic changes of the aging;
- misconceptions concerning addition and tolerance to the opioids.
The Merck Manual (2011) indicates that one of the main challenges facing physicians is managing pain in an individual geriatric patient who is experiencing a multisystem failure and showing considerable signs of pain, such as restlessness, moaning, grimacing, and being not alert enough to respond to questions. Pain control in a geriatric patient experiencing multisystem failure is of a great significance since it increases ventilator function of a patient after surgery, thus resulting to decreased ability to take a deep breath and lowers circulation of hormones released as a result of stress from surgery among other notable aspects.
- Discuss how you would know whether your choice of pain management was successful.
There are many ways in which a physician can determine the level of success of administered drugs to Mrs. Elli Baker, who’s a geriatric patient. For Mrs. Elli Baker, it’s appropriate to administer acetaminophen morphine 0.1mg/kg IM. This is due to her reduced level of consciousness and respiratory distress.
The effectiveness of acetaminophen morphine 0.1mg/kg IM can be assessed by carrying out titration of the dosage, thus effective for patients in this condition. This is where doses are added in small quantities over a given period. The nurses can also employ patient focused outcome measures to Mrs. Elli Baker. This process involves focusing on monitoring changes in patients’ pain experience following treatments. The measures must be administered before and after palliative administering in order to quantify change. Birch (2010) argues that if the intensity of pain after painkiller administration is lower as compared to the intensity prior to painkiller administration, the pain management is successful, but if vice versa, the pain management was not successful.
- Discuss what you learned regarding assessment of the geriatric patient
By effectively treating Mrs. Elli Baker, it is clear that administering treatment for geriatric patients is extremely complicated as compared to other classes of patients. This is due to their unwillingness to respond to questions and exaggeration of their sickness levels among other significant challenges posed to physicians (The Merck Manual, 2011).
- Identify the collaborative team members pertinent to the care of the geriatric patient in the scenario, including the emergency room nurse’s response to changes in the level of consciousness and increasing respiratory distress.
There are various collaborative team members who are very vital in the management of the geriatric patient. For instance, in our scenario, the community health worker and primary care physician can be applied to instigate an assessment when they spot a budding hitch. This is an important aspect, for example, before Mrs. Eli Baker collapsed, she was talking to her friend, and there were some symptoms which arisen, but if there was a community health worker or primary care physician, he/she may have controlled Mrs. Baker condition. Moreover, in the emergency rooms, the nurses and doctor’s are also important collaborative team members in the treatment of the geriatric. For Mrs. Elli Baker, there is a need for the nurses in the emergency department (ED) to ensure they have the capability to safely insert the chest tubes. If the respiratory distress increases, the call nurse should employ the recommended diagnostic tools to evaluate patients experiencing these distresses. Tools like good history, a detailed physician examinations as well as careful chest auscultations should be performed on the patients (Birch, 2010).
From the above case study, one can clearly see the numerous challenges that face the pain management for the elderly. In my own opinion, physicians should develop new methods that will easily be used to treat the elderly generations.