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Additional resources for Critical Care Nursing Made Incredibly Easy! (3rd Edition)
Some patients on the CCU experience chronic as well as acute pain. Examples of chronic pain include: • arthritis pain • back pain • pain from cancer. Don’t look for the signs The nervous system adapts to chronic pain. This means that many typical manifestations of pain—such as abnormal vital signs and facial grimacing—cease to exist. Therefore, chronic pain should be assessed as often as acute pain (generally, at least every 2 hours or more often, depending on the patient’s condition). Assess chronic pain by questioning the patient.
If the patient is already taking NSAIDs, continue to use them as they add to the analgesic effect. Administer nonopioid analgesics, such as acetaminophen (Tylenol), aspirin (Ecotrin), and nonsteroidal antiinflammatory drugs (NSAIDs), to the patient just beginning to experience discomfort and mild pain. Although the patient’s pain might not be adequately controlled with nonopioid drugs, their use may reduce the overall amount of opioids needed to achieve pain control. • nonopioids • opioids • adjuvant medications.
Several factors—such as cultural background and social situation—influence a patient’s interpretation of personal space. A patient’s personal space is limited in many ways by the critical care environment—for example, due to the confines of bed rest, lack of privacy, and use of invasive equipment. You can try to increase your patient’s sense of personal space—even within the critical care environment—by simply remembering to show common courtesy, such as: • asking permission to perform a procedure or look at a wound or dressing • pulling the curtain or closing the door • knocking before you enter the patient’s room.