Many patient's who use drugs and are on opiods, analgesics, benzodiazepines, stimulants, barbiturates, and sedative-hypnotics have the potential to become addicted.
Many people with chronic illnesses, injury, and history of mental illness are prescribed these drugs.
As a nurse it is difficult to assess whether the pain is real or whether the patient is seeking the nacrotic.
Adult patients display pain and emotions differently.
Many patient's become dependent physically and mentally on these drugs.
Patient's History
*One way to assess whether the patient is drug seeking or whether he or she is in true pain is to look at the patient's history.*Does the patient have a history of drug abuse?
*What is the patient's illness?
*What is the patient's medical history?
*Does the patient have a mental illness?
*Does the patient have a history of anxiety or depression?
*Is the patient going into surgery?
*Has the patient just came out of surgery?
*What medical condition would cause the patient to have severe pain?
Nurses Assessment
*Does the patient show nonverbal signs of pain such as crying or grimacing?*Does the patient watch the clock and ask for the pain medication or sedative at the exact time its due?
*Does the patient continually ask for the medication?
*Does the patient continually ask the physician to increase his or her pain medication?
*What is the dose of the medication and how often does the patient ask for it?
*How long has the patient been taking the drug?
*Does the patient have a change in mood and behavior if they don't receive the medication at the exact time?
*Have a conversation with patient. Do they want the medication because they are in pain or because they can't sleep?
*Do they want the medication because the are anxious?
*What is going on in the patient's life?
*What are their social circumstances?
*Is the nursing staff performing three non-drug interventions before administering a sedative, hypnotic or anti anxiety medication?
*How many different medications is the patient on?
*Is the patient gradually asking for less medication as time goes on or are the asking for more?
Assessment Findings
If the patient is continually asking for the physican to increase their pain medication or increase the frequency then he or she needs further evaluation by both a nurse and a physican. There is a good possibility that he or she is in pain. There is also a possibility that he or she is becoming addicted to prescribed medication. The patient's history needs to be taken into account as well. Medical conditions such as cancer and rheumatoid arthitis are chronic condition and can be very painful.In long-term care facilities three non-drug interventions need to be attempted before administering anti-anxiety or anti-psychotic medications. These interventions can be giving the patient food, drinks, one on one care, back rub, changing the patient's position in bed, adjusting the temperature, and redirecting the patient's mental focus. Many times these interventions work, but many times the medication may still need to be administered.
The patient's history and diagnosis are helpful in deciding whether or not the patient is developing a substance abuse problem.If the patient is having any social or relationship problems, then he or she may need to meet with a crisis counselor.
Every shift that a nurse is on duty he or she needs to do an assessment on the patient. If he or she suspects that the patient is becoming addicted, the nurse needs to notify the physician.
Category:Pain
Adapted from the Wikipedia article Pain assessment, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki
