The nurse assesses the client and realizes that client pain is interfering with postoperative therapies. Which does the nurse determine before using medication and relaxation techniques simultaneously to reduce client pain? (Select all that apply.)
1. The client has used guided imagery in the past successfully.
2. Nonpharmacologic relaxation methods appeal to the client.
3. The client moves in the bed and disrupts the nurse incessantly.
4. The provider plans to discharge the client to home in two days.
5. Client understands written information on relaxation techniques.
6. The client cannot receive additional analgesia for unresolved pain.
1, 2, 3, 6
1 and 2. An integrated approach using pharmacological and nonpharmacologic thera-pies is the most effective method of pain management; clients who potentially benefit the most from integrated therapies share certain qualities including successful use of nonpharmacologic therapies in the past. A client who uses relaxation techniques, such as guided imagery and massage, is more likely to find these techniques appealing as long as the client achieves success with the technique.
3. Another client likely to benefit from an integrated approach has anxiety or fear; excessive movements and disruptions are indications of a problem, including anxiety or fear, that potentially the client cannot identify.
6. A client who cannot receive additional pain medication despite continuing pain is likely to benefit from integrated therapy. At times, client anxiety about unrelenting pain escalates the need for pain medication; if the anxiety is reduced, often the need for more pain medication decreases as well. Spending time with the client and there-by creating a simple distraction is often a successful strategy to assuage the cycle of anxiety exacerbating pain.
4. The discharge date is unrelated to assessing the client before relaxation and guided imagery; in fact, it can serve as a distraction to the goal of relaxation therapy
5. The nurse can explain and demonstrate relaxation therapies and guided imagery without the client reading.
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