Author Question: A patient with developmental disabilities and poor verbal communication skills has been admitted for ... (Read 126 times)

debasdf · **on:** Jul 22, 2018

A patient with developmental disabilities and poor verbal communication skills has been admitted for observation after a motor vehicle accident. The patient has been moaning, facial grimacing, and restless since being admitted to the floor.

The nurse needs to first assess the patient for which of the following? a. Safety, because the patient will not use the call light
b. Hydration, because the patient is not able to verbally communicate his or her needs
c. Bathroom privileges, because of lack of communication skills
d. Pain, because the patient is unable to communicate effectively

Question 2

An adult patient has just undergone surgery for repair of a torn left knee anterior cruciate ligament (ACL).

When informing the patient of several pain relief interventions, the nurse most appropriately urges the patient to select which of the following? a. NSAIDs
b. Nonopioids
c. Adjuvant therapy
d. Patient-controlled analgesia pain management

qytan · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

D
Patients unable to communicate effectively often require special attention during assessment. Some examples are the following:
Infants and children
Patients who are critically ill and/or unconscious
Patients with dementia
Patients who are mute or aphasic
Patients with an intellectual disability
Patients at the end of life

These patients all require different assessment approaches. However, be alert for subtle behaviors that indicate pain. Note a patient's vocal response (e.g., moaning, crying, gasping), facial movements (e.g., grimacing, clenched teeth, tightly closed eyes), and body movements (e.g., restlessness, increased hand and finger movements, pacing), or inactivity. While the other responses are appropriate, the patient is currently exhibiting signs of pain, making it the priority.

Answer to Question 2

D
In patient-controlled analgesia (PCA), patients benefit from having control over their pain therapy. Patient-controlled analgesia (PCA) is a safe method for a variety of painful conditions, including but not limited to postoperative, traumatic, sickle cell crisis, cancer, and burns. NSAIDs are nonsteroidal anti-inflammatory agents, which are effective in treating mild to moderate pain. NSAIDs act by inhibiting synthesis of prostaglandins and by inhibiting the cellular responses during inflammation. Adjuvants or coanalgesic agents, such as sedatives, anticonvulsants, steroids, antidepressants, antianxiety agents, and muscle relaxants, have analgesic properties, enhance pain control, or relieve symptoms.