When planning care for the orthopedic surgical client, the nurse would include which approach?
1. Anticipatory pain management prior to therapy
2. Allowing family to assist in pushing the patient-controlled analgesia (PCA) button
3. Administering pain medications only while awake
4. Assessing vital signs to evaluate the degree of pain
Anticipatory pain management prior to therapy
Rationale: Anticipatory pain management will improve the efforts during therapy to speed up the recovery process. Better pain management that is more consistently given will improve outcomes of recovery and client satisfaction. No one should be allowed to push the PCA button except the client. Nursing staff and visitors are not the individuals experiencing the pain; only the client should push the PCA button to regulate the dosage given based upon his or her perceptions. Pain medications should be given around the clock for more effective management of pain at all times. Additional dosages may be needed during increased periods of activity, but by keeping a regulated amount of pain medication present within the body, the muscles are more relaxed and the client is better able to tolerate therapy. Vital signs do not always reflect the degree of pain experienced by the client. Chronic pain management clients with long-term pain issues may not have the same sympathetic responses that are experienced by those in acute pain. Pain is a perception of the individual and should not be judged by the nurse.
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