Homeostasis and Pain Management in Patients with Multisystem Failure
Carrie Tucker
Western Governors University
Contemporary Nursing Issues
GNT1

March 19, 2012

Homeostasis and Pain Management in Patients with Multisystem Failure On arrival to the Emergency Center, Mrs. Baker will be quickly triaged. The nurse will determine her level of consciousness by observing Mrs. Baker's verbal and nonverbal commuionnicat. The nurse will ask her what her name is, what year it is, and where she is at. Mrs. Baker's initial vital signs would be obtained and would include blood pressure, temperature, pulse, respirations, and oxygen saturation level. Mrs. Bakers initial pain level would also be assessed at this time. The triage nurse will also obtain a quick health history as well. Once the triage nurse has given report to the ER floor nurse and MD, Mrs. Baker would be moved from the initial triage area to an ER room. The ER floor nurse will now take over her care. Once again Mrs. Baker's vital signs would be obtained. The ER nurse will then do a more in depth assessment to include heart and lung auscultation, range of motion, reflexes, and pain. The ER nurse will also perform a head to toe skin assessment looking for any bruises, cuts, scrapes, and deep lacerations. Once the assessment is completed, the nurse will notify the MD of her findings. He will then order necessary laboratory and radiology tests. Laboratory tests will include: Complete Blood Count, Comprehensive Metabolic Panel, Arterial blood Gases, and a Urinalysis. The doctor may decide to have Cardiac Enzyme levels tested as well. Since we know that Mrs. Baker is diabetic, we will also test her blood glucose level. Many technological tools will be used for Mrs. Bakers care. We will start off placing her on a heart monitor. This will allow us to see her heart rhythm as well as to take her vital signs on a timed interval. The heart monitor will also provide us with a means of measuring her blood oxygen saturation level to let us know if we need to place her on oxygen. A blood glucometer will provide the health care team with an immediate blood glucose level. Mrs. Baker will also need radiology tests to check lungs for pneumonia and to check for any bone fractures. A CT scan will show if she suffered any head or brain trauma. These tests along with the laboratory tests ordered will help to determine any abnormalities that will affect Mrs. Bakers homeostasis. When assessing any patient you always want to assess the ABC's first: airway, breathing, and circulation. Once it has been established that their ABC's are good, we then must have initial vital signs. Initial vital signs are very important to know so that we know of any changes during the course of the patients treatment. If the patient comes to the ER with any specific complaints or noticeable wounds and or bleeding, this should be given high priority. We will assess for the patients need for intravenous fluid therapy for hydration or electrolyte balances. You then should assess the pt for pain to include location, type, alleviating factors, and if anything makes the pain worse. Pain management is of high priority in the healthcare setting. Pain is subjective and is different for each person. The pain that I may have with a particular disease or problem, is going to be totally different from the pain anyone else has with the same disease or problem. Pain with the elderly is the same way, however the elderly downplay pain a lot. They tend not to complain of a lot of pain because they see pain as a sign of getting older and they just deal with it. They also do not want to cause worry with their family members and other loved ones. Of course it is a lot easier to just be able to ask someone if they are having pain, however that is not always possible. If a patient is alert and oriented, simply do ask them about their pain. You need to ask where it is located, if it comes and