Select a patient that you have recently cared for in your clinical setting where one of the key nursing interventions undertaken by you was the assessment and management of the patient’s pain....

ASSESSMENT AND MANAGEMENT OF PAIN
Table of Contents
Introduction    3
Pathophysiology of Pain, relating to case study    3
Key Issues of the Patient related to their Pain, Pain Management as well as its Effects on their Physical, Economic, Psychological, Cultural, Social, Functional and Spiritual Life    4
Nursing Care related to Patient’s Pain Assessment and Analyzing its Clinical Findings    5
Non-Pharmacological and Pharmacological Interventional Strategies for Managing Pain of the Patient, with Recommendations for Improvement    6
Conclusion    8
References    9
Introduction
Pain is an uncomfortable or disagreeable sensation linked to a particular body part and could be produced by processes or stimuli that damage tissues. Pain generally has physical and emotional aspects to it and can be categorized as Acute, chronic or cancer pain. The pain inflicting stimuli are refe
ed to as ‘noxious’ stimuli. In my clinical setting, I have recently cared for a patient, Mrs. B, who was a 47-year-old obese lady, suffering from Rheumatoid Arthritis (RA). She complained of severe joint pain and weakness of limbs that hampered her performance of daily activities. The cu
ent study is for analyzing her pain assessment, management and its efficiency so that it can have positive effects on her life.
Pathophysiology of Pain, relating to case study
The processing of pain signals
oadly includes four major steps. These consist of transduction, transmission, modulation and perception. Transduction refers to the procedure, by which pain inducing stimuli get transformed to electrochemical signals in nociceptors in the free nerve endings. According to Lindegaard, Gleerup and Andersen (2017), ‘Nociceptors’ refer to the definite set of sensory receptors that recognize the noxious or pain causing stimuli. These receptors are distributed in the skin, viscera, joints and muscles are closely associated to the free nerve endings of the peripheral sensory and sympathetic neurons. They generate electrochemical action potential co
esponding to the sensory stimulation which vary depending on the type of pain stimulus received.
Nociceptors respond only to stimuli of pain. However, as argued by Santana (2014), they can differentially respond to the different sources of pain causing stimuli ranging from thermal to mechanical and chemical stimuli. Transmission follows transduction in the second stage of processing pain stimuli. The peripheral signals are transmitted to the spinal cord, followed by thalamus, and subsequently to cortex. Modulation pertains to changes that happen in the nervous system as a reaction to noxious stimuli. The modulation system of an endogenous pain consists of a consortium of spinal cord sensory neurons and descending neural tracts, inhibiting transmission of the pain signals to higher centers (Aronoff, 2016). The final stage of pain processing is the perception of pain and the ability to perceive and differentiate between early receptions of sharp pain followed by a dull, burning perception in the later phase.
Mrs. B showed symptoms pertaining to the autoimmune disease of Rheumatoid Arthritis. She had been suffering from immense pin in her knee and ankle joints. Her feet would tend to get stiff and immovable. On viewing her case history, it came to light that her paternal aunt also suffered from RA. She was found to be greatly over weight due to her inability to exercise and walk. Besides being genetically predisposed and obese, her age and gender also might have contributed to the disease. According to studies, women were found to be more prone to developing RA. Mrs. B was a smoker previously. Though she quit smoking, the smoking might have aided the onset of RA.
Key Issues of the Patient related to their Pain, Pain Management as well as its Effects on their Physical, Economic, Psychological, Cultural, Social, Functional and Spiritual Life
The patient vehemently complained of an excruciating pain in the joints which had intensified in the past few weeks. She felt that her joints would get locked at times, rendering her unable to move. She had noticed that the condition would tend to worsen in the morning when she would also experience stiffness in the joints. The same also occu
ed when she attempted to move post a period of inactivity, for instance, sitting. She feared that her legs were losing their strength as she perceived tenderness, swelling and heating in her joints. Besides all this, she also complained of mood swings and fatigue.
As mentioned by Sharpe (2016), pain is a physiological and emotional phenomenon. There are psychological facets to every disease including RA. The inability to perform routine activities of daily life with ease might have had an adverse impact on the self-confidence Mrs. B. Additionally, chronic pain by itself causes increased i
itability and depression. It has been observed that depressed people tend to feel greater pain and lack the motivation and hope needed to recover relatively faster. The continuous pain and stiffness prevalent in the joints hamper the ability of the patients to ca
y things and restrict their movement not only in public but also in their houses (Flurey, et al., 2016).
As mentioned by Matcham, et al. (2014), chronic pain associated with RA also affects the economic conditions of the patient. The medical costs incu
ed for the management and control of RA, ranging from medications to joint replacement surgeries, affect the economy of the individual. According to the Arthritis Foundation, the employability of people with RA is much less as compared to those without RA (Gulacsi, et al., 2015). RA imposes limitations on patients with respect to mobility, ability to work for long hours and hence, affect their employability.
RA patients are prone to developing depression,...