Week 1 Case study- Pain, VS and infection prevention You are a nurse caring for a 73-year-old farmer who was brought to your emergency department via ambulance after he fell while caring for his chickens. The external rotation of his left foot indicates the high likelihood that he fractured his hip with the fall. He has returned from radiology after having his hip and pelvis radiographed. He is trying to be brave but is in significant pain. His initial dose of pain medication, while somewhat effective, does not make his pain tolerable. Pain vs. and Infection Prevention Pain vs. and Infection Prevention A. Which cues (assessment finding) would signal the presence of severe pain in your patient? B. How would you accurately measure his pain level? C. What characteristics of his pain would be appropriate to assess? D. Which situational circumstances can affect an older adult’s pain perception? E. What nonpharmacologic measures can effectively decrease pain? F. How could relaxation positi

Pain vs. and Infection Prevention

Part One

Cues indicating severe pain in the patient may include verbal cues where the patient describes their pain as “excruciating,” “unbearable,” or “the worst pain I’ve ever felt.” Non-verbal cues can also signal severe pain, such as facial grimacing, restlessness, agitation, or guarding the affected area. Vital signs like increased heart rate, elevated blood pressure, and rapid, shallow breathing can further indicate severe pain (Harrison et al., 2021).

Accurately measuring the patient’s pain level can be done using the Numeric Rating Scale (NRS). Here, the patient rates their pain on a scale from 0 to 10, with 0 being no pain and 10 being the worst possible pain. Descriptors like mild, moderate, severe, or unbearable can also assess pain levels accurately (Harrison et al., 2021).

Characteristics of the patient’s pain that would be appropriate to assess include the location of the pain (like hip area), the quality of the pain (such as sharp, dull, throbbing), the duration of the pain (such as constant, intermittent), and the exacerbating or relieving factors (such as movement, rest, medication) (Harrison et al., 2021).

Situational circumstances affecting an older adult’s pain perception include cognitive impairment, sensory deficits, comorbidities, and medications. Conditions like dementia or delirium can impact patients’ ability to communicate their pain effectively. Sensory deficits, such as hearing or vision impairments, can make it challenging for older adults to express pain or understand pain-related instructions (Harrison et al., 2021). Comorbidities like arthritis or diabetes can amplify pain perception due to inflammation or neuropathy. Also, certain medications, such as opioids or sedatives, can affect pain perception or mask pain symptoms.

Nonpharmacological measures that can effectively decrease pain include positioning and immobilization to reduce pressure on the affected area, cold or heat therapy to alleviate pain and reduce inflammation, distraction techniques like engaging in enjoyable activities, and relaxation techniques such as deep breathing exercises or guided imagery (Harrison et al., 2021).

Relaxation positively affects the patient’s pain by promoting a sense of calmness and reducing muscle tension. Relaxation techniques can help distract the patient from the pain, release endorphins, and enhance overall well-being (Harrison et al., 2021).

Part Two

To prevent infectious agents from being introduced during catheter insertion, the healthcare provider should first perform proper hand hygiene before the procedure. This involves thorough handwashing with soap and water or using an alcohol-based hand sanitiser. Second, the healthcare provider should wear appropriate personal protective equipment (PPE) such as gloves, a gown, and a mask (Aghdassi et al., 2020).

Potential reservoirs for an infection that could contaminate the catheter insertion include the patient’s flora. The patient’s skin and mucous membranes can harbour microorganisms, which, if introduced into the urinary tract during catheter insertion, can cause infection. Additionally, the healthcare environment itself can serve as a reservoir for infection (Aghdassi et al., 2020). Contaminated surfaces and equipment within the healthcare setting can be sources of infectious agents.

Correctly utilizing sterile technique impacts breaking the cycle of infection. The sterile technique involves maintaining a sterile field and using sterile equipment during the procedure. By adhering to sterile techniques, the healthcare provider minimizes the introduction of pathogens into the patient’s urinary tract (Aghdassi et al., 2020).

Violation of the sterile technique can introduce pathogens during the catheter insertion procedure. For example, pathogens can be introduced if non-sterile equipment or contaminated hands come into contact with the catheter or insertion site (Aghdassi et al., 2020). Improper handling or manipulation of the catheter or failure to maintain a sterile field can also lead to contamination and the introduction of infectious agents.

Several factors make the patient a susceptible host to infection. Age can play a role, as older adults may have a weakened immune system or underlying health conditions that compromise their ability to fight infections. Comorbidities like diabetes or immunodeficiency disorders can also increase susceptibility (Aghdassi et al., 2020). Additionally, any skin integrity breach, such as the catheter insertion site, provides an entry point for pathogens. The patient’s overall health status, previous exposure to infectious agents, and the presence of any indwelling medical devices, li