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

[Blackheartednurse]

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.

I dont understand..

[HeartsOpenWide, RN]

I dont understand..

If they are FVD and you give them a whole does of Diludid its going to process as a lot more than if you had efficient fluid volume...ever notice how much more you get drunk on an empty stomach than when you have eaten something? I know, lame analogy.

[iteachob, MSN, RN]

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.

Trust me....on NCLEX pain is very much considered psychosocial. I never said I agreed with that (I do understand that the patient experiences it as physical), but, I do teach for a company that does NCLEX review (I won't mention the company), and that is one of the "rules"......to consider pain a "psychosocial" phenomenon.

[ghillbert, MSN, NP]

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

fluid volume deficit is definitely a c of abc.

[PostOpPrincess, BSN, RN]

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

I do not completely disagree, but I also considerably disagree...if that makes sense.

Pain can create life-homeostatic dysfunction--physical and psychosocial.

In this case, you have to fix the fluid volume because if would be difficult to give pain med to someone with a B/P of 60--vasodilation r/t fluid volume deficit, then vasodilation related to narcotic IV. It would be a mad cycle.

[PostOpPrincess, BSN, RN]

Trust me....on NCLEX pain is very much considered psychosocial. I never said I agreed with that (I do understand that the patient experiences it as physical), but, I do teach for a company that does NCLEX review (I won't mention the company), and that is one of the "rules"......to consider pain a "psychosocial" phenomenon.

Yikers~

So..I will tell the post-op, burn patient that his pain is all in his mind and to try and find a zen place.....

*snarky towards the NCLEX review*.....not towards Kanzi, who probably laughs at some of these questions.....

[kanzi monkey]

Trust me....on NCLEX pain is very much considered psychosocial. I never said I agreed with that (I do understand that the patient experiences it as physical), but, I do teach for a company that does NCLEX review (I won't mention the company), and that is one of the "rules"......to consider pain a "psychosocial" phenomenon.

My recollection from taking a course for that beast of an exam is that pain was pretty much NEVER the priority answer--but I don't recall it being relegated entirely out of the physical realm.

[geekgolightly, BSN, RN]

whats gonna happen to that tanked pressure when you treat the pain with narcotics?

[~Mi Vida Loca~RN, ASN, RN]

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.

My nursing school teaches us that pain is the 5th vital sign, but they also have taught us that Fluid and Electrolytes is so much of nursing and a deficient fluid volume would be a priority over pain.

I believe in my school we are taught to look at the pain when the patient is stable if we are talking about an emergency situation.

[iteachob, MSN, RN]

i do not completely disagree, but i also considerably disagree...if that makes sense.

pain can create life-homeostatic dysfunction--physical and psychosocial.

in this case, you have to fix the fluid volume because if would be difficult to give pain med to someone with a b/p of 60--vasodilation r/t fluid volume deficit, then vasodilation related to narcotic iv. it would be a mad cycle.

exactly! therefore, the physical (fvd) trumps the pain ("psychosocial".........i know, and physical, too) as far as priority, since it has to be dealt with first.

[Virgo_RN, BSN, RN]

What is going to kill the person the quickest?

[blondy2061h, MSN, RN]

In burn patients, rehydration is called "fluid resuscitation." This, plus preventing infection, is what's going to save their life. The nice thing about reality is that you can treat both.