Pain Management Assignment Paper

S – Situation:

My name is nurse Edwards from the pain management ward. I’m calling to report the increase of pain intensity in inpatient K.C. because; she reports a pain of 9 and has been requesting pain medication every 4 hours

B – Background:

K.C. was admitted in the morning for yesterday afternoon for increasing back pain. She has Regular insulin per sliding scale and Hydrocodone-APA10-325 (Norco) 1-2 tabs every 4 hours since she was admitted. Her last dose was 3 hours ago. She is diabetic and her back pains began four years ago from an injury gotten at work. K. C. has been having epidural steroidal injections to control her pain since last month. Pain Management Assignment Paper

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A – Assessment:

Her current observations are:

Pulse: 90, BP: 180/90, Resps: 20, W: 280 lb

She is crying intermittently and is restless in bed and rates her pain 9.

R – Recommendation:

I would like you to come and see the patient immediately.

In the meanwhile, is there anything I should do to make the patient comfortable; or anything that you might require during the assessment of the client?

Additional information to know prior to calling the charge RN

            Prior to calling the RN, I would want to know additional information regarding the patient. This includes the patient’s code status (Shahid & Thomas, 2018). I will also need to know the allergies and vital signs as well. I will also consult with the other nurses to know if they were aware of the patient’s problem before making the call. In addition, I will access the chart and open to the last set of orders that were written and also note the IVs that are running, and drip rates (Stewart, 2016).

References

Shahid, S., & Thomas, S. (2018). Situation, background, assessment, recommendation (SBAR) communication tool for handoff in health care–a narrative review. Safety in Health, 4(1), 7.

Stewart, K. R. (2016). SBAR, communication, and patient safety: An integrated literature review. Pain Management Assignment Paper