N109: Foundations in Nursing Practice

N109: Foundations in Nursing Practice Study Guide • Music therapy is an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals. The nurse can also use music to help the patient relax. • Ice and heat application may be helpful, but inappropriate use may also be harmful. Ice and heat may interfere with circulation, particularly in the elderly and very young or those with circulatory problems. o Cold therapy with ice is the best immediate treatment for acute injuries because it reduces swelling and pain. Ice is a vasoconstrictor (it causes the blood vessels to narrow) and it limits internal bleeding at the injury site. To ice an injury, use a high-quality ice pack that conforms to the injury site. Apply the ice pack for 10-20 minutes at a time, and reapply after the skin temperature has returned to normal. o Heat therapy is more useful for chronic injuries or tight muscles. Because heat increases circulation and raises skin temperature, do not apply heat to acute injuries or injuries that show signs of inflammation unless ordered by a physician. Safely apply heat to an injury 15-20 minutes at a time, and use enough layers between the skin and the heating source to prevent burns. • Massage is the manipulation of superficial and deeper layers of muscle and connective tissue to promote relaxation and well-being. Again, although there are professional massage therapists, the nurse can also provide a simple back rub to enhance relaxation, comfort, and sleep. • Transcutaneous electrical nerve stimulations (TENS) can be used to close the gates for nerve transmission. In this modality, a battery-powered unit transmits a small electrical impulse across the painful area through electrodes attached to the skin. Although the exact mechanism of action is not well understood, the use of a TENS unit may be helpful in breaking a cycle of chronic or acute pain. • Education about the disease process and all treatments and procedures can help the patient understand what is happening and accept the probable course of the illness. This knowledge can be very comforting and can help relieve stress, and consequently relieve pain. 2.9 Pharmacological Treatment Modalities Pharmacological pain relief may be achieved by using one or more categories of medications to reduce pain, inflammation, or anxiety. These categories of medications include: • Narcotics work in the central nervous system to relieve pain and alter the patient’s perception of pain. The use of narcotics may block the perception of pain, allowing the individual to complete therapies and treatments that may change the course of the illness or disease. The nurse should be aware that the side effects of narcotics may include drowsiness, constipation, nausea and vomiting, and respiratory depression. If a patient on narcotics experiences increased sedation or respiratory depression, the nurse should discontinue the narcotic and notify the prescribing provider. • Non-narcotic analgesics include many of the over the counter (OTC) medications that an individual can purchase without a prescription. In general, this classification of pain relievers works on the peripheral nervous system by decreasing the inflammatory response at the injury site. The nurse should be aware that this class of drugs may precipitate gastrointestinal pain and bleeding.

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