Patient Profile Mrs. K. is a 280
Patient Profile Mrs. K. is a 280 pound (112 kg) 48 year old African American woman admitted for an incision and drainage of a right renal abscess. Lab results indicate methicillin-resistant Staphylococcus Aureus (MRSA) in her wound drainage. Subjective Data • RN for 20 years • Lives alone • Desires 0 pain during therapy but will accept 1 2 on a 0 10 scale • Reports incision area pain as a 2 3 between dressing changes and as a 10 during dressing changes • Reports pain between dressing changes controlled by two Percocet tablets • Reports morphine 2 mg IV barely touches pain during dressing changes Objective Data • Requires qid dry-to-dry dressing changes for 1 week • Morphine 2 to 10 mg IV every 1 to 2 hours Critical Thinking Questions 1. Initially, what dose of IV morphine should be given? 2. Describe the assessment data that supports the dose selected in 1. 3. How long should the nurse wait after the IV morphine dose to begin the dressing change? 4. If an initial dose of 6 mg IV morphine reduces the pain to a 6 during the dressing change, what nursing action is indicated? 5. What dose should be administered for subsequent dressing changes? 6. What additional pain therapies might the nurse plan to help Mrs. K through the dressing change? 7. When Mrs. K. is discharged needing dressing changes for 3 days at home, how would the home care nurse organize her care for optimal pain management during the dressing change? 8. Discuss additional nursing interventions needed for Mrs. K. as a result of her MRSA. Include precautions for this client both in hospital and at home. 9. What are the priority nursing diagnoses at this time? Others? 10. Based on the data presented, develop a nursing care plan for acute pain. Follow instructions outlined for this assignment. SCIENCE HEALTH SCIENCE NURSING NURSE 400
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