Medical-Surgical Nursing 9th Edition by Sharon Lewis ,Shannon Ruff Dirksen,Margaret McLean Heitkemper,Linda Bucher

Exercise 1

Patient Profile
K.C. is a 280-lb (127-kg) 68-year-old African American woman with diabetes who was admitted for an incision and drainage of a right abdominal abscess. She is being discharged on her second postoperative day. Her married daughter will assist with dressing changes at home.
Subjective Data
• Lives alone
• Desires 0 pain but will accept 1 or 2 on a scale of 0 to 10
• Reports incision area pain as a 2 or 3 between dressing changes and as a 6 during dressing changes
• States sharp pain persists 1 tO₂ hours after dressing change
• Reports pain between dressing changes controlled by two Percocet tablets
• Has history of fibromyalgia and is complaining of pain "everywhere"
Objective Data
• Requires qid dressing changes after discharge
• For discharge, Percocet (two tablets q4hr for pain PRN) is prescribed
1. Describe the assessment data that are important for determining whether K.C. has adequate pain management.
2. How long should the daughter wait after the Percocet is given to begin the dressing change
3. What additional pain therapies might you plan to help K.C. through the dressing change
4. Priority Decision: What are the priority nursing interventions for K.C.
5. What side effects might she experience because of her pain medication How can these be managed
6. Delegation Decision: To whom can you delegate teaching K.C. and her daughter the plan of care at home
7. Priority Decision: Based on the data presented, what are the priority nursing diagnoses Are there any collaborative problems
8. Evidence-Based Practice: K.C.'s daughter asks you if any other strategies could be used to help decrease her mother's incisional pain and her overall fibromyalgia pain.