Need help with interventions on pain

hi, mybabyjhay, and welcome to allnurses! :welcome:

you have given us a nursing diagnostic statement of pain r/t decreased oxygen supply to tissues. breaking this down it represents the following:

first of all, you've got a big problem with the diagnosis and related factor here. if you will refer to a nanda nursing diagnosis reference you will find that you have diagnosed this incorrectly and the related factor you have listed is not an appropriate related factor for pain. you need to correct that. if this patient is, indeed, having a decreased oxygen supply to his tissues, then pain is not his main problem, and a different diagnosis is needed: ineffective tissue perfusion and it will need to be related to some underlying pathophysiology of his/her disease process--not pain. pain is merely a symptom of the problem.

here are weblinks that have nanda information on the nursing diagnoses of acute and chronic pain. the difference between the two is the length of time that the pain has existed. read the definition of the two diagnoses very carefully before deciding which diagnosis to use. the patient will need to have symptoms of the pain. you will find symptoms (defining characteristics) of the pain listed on the websites listed below.

• [color=#3366ff]acute pain
  
• http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=40
  
• [color=#3366ff]chronic pain
  
• http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=41
  

next, any nursing interventions must be based upon your patient's defining characteristics (signs and symptoms) of the pain. this is information that can only be obtained during your assessment and interview of the patient and collection of medical record data. you haven't listed any of that information in your post. so, there is no way i can intelligently give you specific interventions for this patient. only you know what the symptoms were that this patient was specifically experiencing. the links i posted above do have some nursing interventions listed on them. perhaps you will find some help in them. or, if you list your patient's symptoms of their pain i can help you with some interventions.

how about ineffective peripheral tissue perfusion r/t impaired circulation. the disease is anemia... thanks really need your help:o

do you have a nursing diagnosis reference? you need to refer to one to get this diagnosis worded (and classified) correctly. what are your patient's symptoms of the anemia?

ineffective tissue perfusion ([color=#3366ff]ineffective tissue perfusion specify type: renal, cerebral, cardiopulmonary, gastrointestinal, peripheral and http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=55) must be specified as being renal, cerebral, cardiopulmonary, gastrointestinal or peripheral. that can only be decided based upon your patient's symptoms. the related factors for this diagnosis are:

• altered affinity of hemoglobin for oxygen
  
• decreased hemoglobin concentration in blood
  
• enzyme poisoning
  
• exchange problems
  
• hypoventilation
  
• hypovolemia
  
• hypervolemia
  
• impaired transport of oxygen
  
• interruption of blood flow
  
• mismatch of ventilation with blood flow
  
• page 229, nanda-i nursing diagnoses: definitions & classification 2007-2008

to determine which of these would apply to your patient you need to know why they are anemic. this would come from reading the patient's chart and knowing something about their medical history. do you know why this patient is anemic?

and, again, what are the symptoms of their anemia. i'm looking for things like:

• fatigue
  
• weakness
  
• dizziness
  
• light headedness
  
• syncope
  
• bruising
  
• shortness of breath
  
• headaches
  
• inability to concentrate

those are the kinds of things that you develop nursing interventions for.

thanks

symptoms are: fatigue, weakness, generalized malaise, skin pallor, tachycardia, and shortness of breath... i need interventions for that symptoms... i'm so confused and tired...

ok, now we're getting somewhere. in your nursing textbook(s) you need to look in the index at the back of the book for each of these things:

• fatigue
  
• weakness
  
• malaise
  
• pallor
  
• tachycardia
  
• shortness of breath (dyspnea)

see if the book has any nursing suggestions for things you can do for patients that have these symptoms. and, you will have your nursing interventions. ask yourself what you will do to help a patient that has fatigue get their adls (activities of daily living) accomplished. is the patient able to eat without assistance? can they get up and walk to the bathroom without assistance or are they too tired and fatigued to do that? if they are, how can you help them? bedpan? provide one or two people to assist them in walking to the bathroom? if the underlying anemia is due to an iron deficiency, did the doctor order an iron supplement to be given? if so, then one of your nursing interventions should be to make sure that this iron supplement is being given as ordered. another intervention should be to teach the patient why the iron supplementation is important for them to take and continue taking. do you see how asking these kinds of questions helps to get you to the nursing interventions? always think about how your patient's symptoms and accomplishing their adls will work together.

hope that helps and gets you started with this assignment. maybe you should get some rest and then start again on this when you are more refreshed and have had some time to think about all this.

anemia

objective: fatigue, weakness, generalized malaise, skin pallor, tachycardia, and shortness of breath

assessment: ineffective peripheral tissue perfussion r/t impaired circulation.

planning: ?

intervention: ?

evaluation: the patient should maintain optimal tissue perfussion to the periphery, aeb strong peripheral pulses, good capillary refill, and good movement.

no! the above is all wrong!

objective: ineffective tissue perfusion, peripheral r/t [you still don't have a proper cause identified - this is based on what is causing the patient's anemia - see the list i gave you above]

assessment: fatigue, weakness, generalized malaise, skin pallor, tachycardia, and shortness of breath

planning: the patient should maintain optimal tissue perfusion to the periphery, aeb strong peripheral pulses, good capillary refill, and good movement; patient's fatigue and malaise will be improved; patient will be able to move about without any shortness of breath

interventions: to be developed

evaluation: was the patient's problem(s) resolved? were the goals achieved? are the interventions appropriate and still current, or do they need to be changed and updated?

thanks again in assessment it is also viewed here as diagnosis abd objective is a form of assessment... the evaluation came from my med surg book... i'm really confused

don't know what kind of english you're speaking down there in the philippines, but up here in the u.s. the word "assessment" means to appraise or judge. in the medical and nursing professions it means to do an appraisal of a patient's health status. the nursing diagnosis comes after the assessment and is based upon the abnormal assessment data items. the nursing diagnosis is actually a statement of the problem(s) that the patient has. the nursing diagnosis is actually nothing more than words, a label, for the problem(s) that the patient has. this is all based on the 5 steps of the nursing process.

1. assessment (collect data from medical record and by doing a physical assessment of the patient)
   
2. nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnosis to use)
   
3. planning (write measurable goals/outcomes and nursing interventions)
   
4. implementation (initiate the care plan)
   
5. evaluation (determine if goals/outcomes have been met)

i don't know what the philippino nursing programs are doing with, or to, the nursing process down there in the philippines either, but it doesn't sound like you are doing the same thing with it that we are. therefore, it makes it very hard for me to help you.