Pain Management And Assessment: Pharmacological And Non-Pharmacological Approaches

Data Assessment of Paul and Molly’s Pain

Question:

Discuss about the Improving Pain Treatment in Children.

Pain is spiteful emotional and sensory situation which is linked to significant tissue damage. Pain can either be moderate, acute or chronic depending on the severity and time (Schreiber, et al., 2014). Pain is associated with different reactions such as change in body temperature, heartbeat rate and even unconsciousness.The case presented involve Paul Jones and Molly who has pain due to fall. The pain management and assessment approach for the two patients will differ depending on their ages and also the associated clinical conditions and this will form the basis of the contrast in the essay.  Some of the issues which will be contrasted are the pharmacological and non-pharmacological approaches to pain management and how the evaluation can be done to meet the needs of the patients

There exist different data which can be used to assess the pain in any incidence. However, in regards to the cases of Paul and Molly, there is enough data that the two patients are undergoing pain. First and for most, one of the elements to assess the two cases is the location of the pain. Both are feeling pain in their forehead. There is swelling of 3cm from the two patients and both are having different qualities of pain. Also, both are having pain scale of 6/10 to mean that their pain is moderate. However, the two patients have vomited twice and this is one of the associated reactions to pain (Kozlowski, et al., 2014). Nevertheless, we can know that someone is suffering from pain if there are cries and complains and this is evident in Molly where she cries when woken. Furthermore, the HR of Paul is one of the data which is giving evidence that there are reactions to pain in his body. He has HR of 108 which is an irregular condition. Additionally one of the data indicated by patients is drowsiness. This is a behavioral reaction to pain and it is evident from Paul and Molly that the two are suffering from the agony of pain.

The change in BP in our bodies is an indication of an abnormal physiological function taking place in the body. The BP of Paul is high; not to the standard to mean that he reacted to pain.  Molly is a child who needs assistance in term of interpretation and the assessment plan should involve some questions and physical assessment and presence of her mother are crucial to providing more information about her feeling (Frank, 2015). For the case of Paul, he is able to offer the necessary information, therefore assessment will be done according to information provided by him.

Pharmacological Approach to Pain Management

There exist different ways which pain can be managed. One of the methods of pain management is the pharmacological approach. The use of drugs is appropriate but the drugs for the child will not be the same as those of elderly. Most drugs which will be given to Molly will be syrup because she might not be in a position to swallow tablets. Also, the injection will be appropriate (Lalloo & Stinson, 2014). This should be the frequently used methods in the treatment of acute and chronic pains in children. In regards to the moderate pain of the Molly and Paul, non-opioid analgesics are significant to manage their pain. These are drugs such as paracetamol, aspirin, and anti-inflammatory.  But for Molly, ibuprofen, and paracetamol are the best for her age. Aspirin should not be given to her, however, Paul suits any of the above. The selection of drugs does vary depending on some factors such as the time of action, adverse effects or route preferences. The selection of these drugs administration on the two patients will be made in accordance with the step principle (Schug, & Goddard, 2014). Opioid and addition of NSAID such as Aleve, Naprosyn, and Anaprox should be given to Paul concerning his age and hypertension condition. It will assist in managing the healing and treatment process. In addition to these, the adjuvant drugs should be added. These adjuvants will assist in improving the symptoms which are associated with pain. Furthermore, unless these or any other drug are useful for the child, the invasive attempts can be tried.  There are several side effects of the analgesic drugs for instance drowsiness, constipation, fatigue, and anxiety. Constipation is common side effects for opioid drugs and a there should be a treatment plan for each and every pharmacological method in order to save Molly and Paul from any side effects which can affect the treatment plan. As a way to evaluate and meet the treatment need of each patient, the reaction to the drugs should be monitored for behavior and inquiries about the same (Hadjistavropoulos, et al., 2014). A comfortable and happy Molly will be a sign of positive response and vice versa. If there is no better response to the drugs, a more efficient drug should be administered to counter the ongoing pain agony.

Another management approach is the use of the non-pharmacologic method. Even though this approach is best for Paul and Molly, they will differ on how they will be applied. The approach forms part of integral pain management at the beginning throughout the treatment period. These methods have been found to be effective for children and adults.  They are much easy to learn and should be applied as possible in order to give the child control in pain management, however, the non-drug approaches should be used but not to replace the recommended method by the physician (Krauss et al., 2016). For instance, the supportive methods are intended to improve and promote the psychological care of the kids. Another method which can be used to manage pain is the cognitive approach. It is intended to influence the thoughts of the patient. For Molly, parents are very skilled on utilizing these methods because they know the preferences of their children (Karstensen et al., 2016).

Non-Pharmacological Approach to Pain Management

The use of distraction is meant to focus away from the attention of the patients from the pain they are going through. The pain score of Paul and Molly is sufficient for this method. Members of their families will engage with the patients and try to make them busy with some tasks such a watching a movie for Paul and playing with toys for Molly. Studies have shown that virtual reality has been found to be a useful distractor of attention in painful medical interventions. Listening to music is one of the methods which can decrease body temperature, heart rate, breathing rate and blood pressure. Furthermore, studies also show that the process of listening to increase wellbeing and relaxation and the level of tension is increased (Schroeder et al., 2016). It will be very evident from the response they give to judge the reaction to the treatment methods. If there is still signs of discomfort and restless among the patients then it would be high time to change the therapy.

 Behavioral methods also have a potential role in managing the pain. Paul will be differently handled based on his understanding of the procedure. It is a simple way which focuses on attention and reduces the tensions on muscles (Makris et al., 2014). If Paul is told to hold his breath during the painful procedure, it will transfer his attention and concentration breathing and not on the procedure. He might be under lots of tensions due to his age but muscle relaxation will assist him in reducing physical and mental tension.  As for Molly, I believe that this method is not suitable for her due to her age, she might not understand what is going on and end up pained more (Malec & Shega, 2015).  As a matter to evaluate if the need of patient has been met; pain relief, there should be an examination of the behavior because if the patient will not be comfortable, then he or she will show through physical appearance.

The location of the pain undergone by the two patients is forehead and the physical methods of pain management are also encouraged. Both will qualify for the procedure. Touch is crucial for children and even old people. This involves holding, stroking, massaging the forehead.  The age bracket from the two patient can be bored by much talking and the best way to relieve pain is through touching (Ambrose & Golightly, 2015). The use of warm hands should be encouraged during the process. It is also important to talk with the patients on what is going on and even involved in planning the process.  Furthermore, the use of cold ice is encouraged where it is wrapped to allow comfortable sensation of cold without bringing any damage to the skin.  The physician should be keen to avoid any injury to the patient and this will be ensured through asking the patient the way he or she feels pertaining the treatment.

Behavioral Methods

Conclusion

The methods used to manage pain for Molly and Paul are different irrespective if they are pharmacological or non-pharmacological. This is important considering their ages and the ability to respond to the very methods. Cognitive approach is the best approach for both Paul and Molly and will work based on the abilities of their trainers to coach them. The use of drugs to manage pain is a different case. Drugs for children are not same with those of adults. However, Paul has a history of hypertension and will have to avoid steroid drugs. It is important that nurses should involve members of the families on the approaches to pain management as it makes the healing process faster. These people also understand well about their patients and they can bring in more ideas to assist the same. Pain management is a critical process which aimed at relieving the patient of the agony undergone. The pain can be facilitated by other conditions and also body can react to it differently as seen from the case of Molly and Paul.

References

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