Which is of a more importance; acute pain or deficient fluid volume?

[Blackheartednurse]

I'm going over my reference book and I find prioritizing nursing diagnoses so hard except the obvious Abc....I'm just covering the nursing care for a burn patient and I was wondering which diagnosis takes priority :acute pain or deficient fluid volume,also if the patient is diagnosed with deficient blood/fluid volume will they automatically suffer from impaired gas exchange and if so this is of the outermost importance? Thanks

[libbyjeanne]

If your in nursing school, its going to be Acute Pain. You treat pain as your fifth VS.

BUT if you show evidence of severe, life threatening deficient fluid volume (like low BP) then that would take priority.

[meandragonbrett]

Acute pain vs deficient fluid volume. I would say deficient fluid volume as that falls under circulation.

[leslie :-D]

i'm going with deficient fluid volume.

deficient fluid volume could affect perfusion, lytes, healing, and increase risk of infection.

leslie

[ohmeowzer RN, RN]

deficient fluid volume.. they can die from that.. then they wouldn't need the pain med anyway... the fluid volume is critical ...

[iteachob, MSN, RN]

Definitely deficient fluid volume over pain. And always remember (especially on NCLEX) physical needs over psychosocial ones. Pain is considered psychosocial.

[kanzi monkey]

For school purposes, deficient fluid volume (circulatory compromise).

In reality, if it's in the same patient, I might go with pain first (if the patient is able to show how much pain he is in, usually he'll be stable enough for me to at least medicate him before getting fluid up--but it depends on the circumstances). Likely it will be just as easy to do both at once.

If you have one patient with acute pain and another pt with deficient fluid volume, that would depend on how serious the volume loss is. If your patient has no blood pressure, is very tachycardic, or is, let's say, on the floor, you must stay with that patient. If your other patient is screaming and crying in pain, this is a time to tap into the teamwork mojo of your floor, and ask another nurse to help you out.

[netglow, ASN, RN]

Then of course if you got the two (say both are noteable), and pt doesn't have a line, and you give dilaudid for example, you might just have screwed yourself.

[HeartsOpenWide, RN]

FVD...no one ever died of pain.

[CharlieT]

Blackhearted,

"with deficient blood/fluid volume will they automatically suffer from impaired gas exchange and if so this is of the outermost importance"

I think you answered your own question, get the volume up before addressing the pain issue. The patient can survive a little pain for a little while.

[Blackheartednurse]

deficient fluid volume.. they can die from that.. then they wouldn't need the pain med anyway... the fluid volume is critical ...

These arethe almost exact words my teacher told me..you wont die of pain but you can most certainly die fluid loss but in nursing school they always stressed the importance of treating pain that often students ended up choosing acute pain..

[kanzi monkey]

Definitely deficient fluid volume over pain. And always remember (especially on NCLEX) physical needs over psychosocial ones. Pain is considered psychosocial.

No.

Pain control is a physical need. Very much so. An entire field of medical study is devoted to pain--pathophysiology, classification, long-term and short term effects (both physical and psychologic), management, treatment, etc.

There is no WAY pain is considered psychosocial. And acute pain is a priority--just not over an acute ABC issue.