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PAIN MANAGEMENT AND CARE Jasmine Espinoza

Independent Study Mentorship

AFTER SURGERY Fall 2017

Mrs. Click
 This is a disclaimer
that some information
was obtained from
outside sources.
ERIN QUINN, RN
Mentorship Site:
Jennie Sealy Hospital
Mentors Place of Business:
PACU (Post Anesthesia Care Unit)
Mentors Profession:
Nurse, RN
Education:
NC 3- ADN- RN
State of Texas (BON) Board of Nursing requirements

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INDEPENDENT STUDY MENTORSHIP
What is ISM?
ISM (Independent Study Mentorship) is a course in which a student accompanies a
mentor in their selected field of study as the mentor performs their daily job functions.
In turn, the student attains a snap shot of what is required to perform their future job
selection.
Course Requirements?
Each week a journal entry is due, 3 hours of mentorship hours, as well as 2 activity
hours. Another requirement is to have an online portfolio to show all of the course
work completed. My portfolio is available for viewing at
https://www.jasmineespinozaism.weebly.com.

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MY TOPIC
What Exactly Is It?
My topic for my presentation is Pain Management and Care After Surgery. It will go
in depth to what effects anesthesia has on our body and how that effects our pain
after surgery. It will also include the most common drugs used to control the pain in
the PACU and how to alleviate pain.
Why Did I Choose It?
I chose my topic because I wanted to gain insight as to what really happens after
surgery and all of the factors that play into how much pain a patient feels after
surgery. It would be interesting to know how that pain can be alleviated in and out of
the hospital.

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ANESTHESIA AND PAIN
Anesthesia is a very powerful drug that can control your pain levels during and
after surgery.
In a recent article published by Psych Central a study conducted by Jaime L.
Baratta, M.D., director of regional anesthesia at Thomas Jefferson University
Hospital, it showed how unrealistic the patients thought their pain would be after
surgery.
A study was performed to split patients up into groups based on the types of
general anesthesia they would be undergoing. There was a group for spinal, another
for epidural and another for peripheral nerve block. Results varied.

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CONT.
The study included 223 patients, averaging 61 years old, who were undergoing
orthopedic, neurosurgical, or general surgery procedures. Of these, 96 received some
type of regional anesthesia (spinal, epidural, or peripheral nerve block). Of the 96
patients, 80 had no general anesthesia, while 16 had general anesthesia with a
peripheral nerve block before or after surgery. The remaining 127 patients received
only general anesthesia.
The patients completed a survey to see what they thought their pain level would be
after surgery and a day after surgery. An hour after surgery they ranked their pain
on a scale from 1- 10. Then a day after surgery they ranked their pain on a scale
from 1-10.

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CONT.
The patients average expected pain rate after surgery was a 4.66, compared to
an actual pain rate which was a 2.56. The patients average expected pain rate a
day after surgery was a 5.45, compared to an actual pain rate of 4.30.
One of the co-authors to this study stated With advancements in regional
anesthesia, great strides have been made in preventing postoperative pain. Given
the clear benefit of patient education and anxiety alleviation on postoperative pain,
providers must find ways to effectively manage patient expectations to help improve
outcomes.

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MEDICATION USED TO CONTROL PAIN AND
DISCOMFORT
Most pain medications used in the PACU contain opioids in them. Opioids act as pain
killers and produce morphine like effects. The most common pain and discomfort
medications used in the PACU are:
-Fentanyl
-Zofran
-Toradol
-Dilaudid
-Demerol

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FENTANYL
Fentanyl is a type of anesthesia that helps prevent pain after surgery. Fentanyl is
injected through your IV and into your bloodstream . It should only take a couple
minutes to actually work.
Some side effects may include:
-Dry Mouth
-Increased Thirst
-Lightheadedness
-Loss of Appetite
-Lower Back or Side Pain

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ZOFRAN
Zofran blocks chemicals in the body that may trigger someone to have nausea and
vomiting. With people who are prone to being nauseated they shouldnt take other
medications such as Fentanyl because it may trigger it.
Some side effects may include:
-Diarrhea or Constipation
-Headache
-Drowsiness
-Tired Feeling

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TORADOL
Toradol works by reducing hormones that causes pain and inflammation in the body.
When using Toradol it is important that you dont use any other NSAIDS or aspirins it
can cause dangerous and unwanted side effects.
Some side effects may include:
-Nausea and Stomach Pain
-Headache
-Swelling
-Dizziness, or drowsiness
-Indigestion and Diarrhea

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DILAUDID
Dilaudid is a n opioid it is used to treat moderate to severe pain. You should not use
Dilaudid in larger amounts or for longer than its prescribed it can be fatal.
Some side effects may include:
-Constipation, Nausea, Vomiting, Stomach Pain
-Dizziness, Drowsiness
-Headache, Tired Feeling
-Dry Mouth
-Sweating, Mild Itching
-Feelings of extreme happiness or sadness

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DEMEROL
Demerol is also an opioid that can treat moderate to severe pain. You should not
use if you have severe asthma or breathing problems. A meperidine overdose can
be fatal, especially in a child or other person using the medicine without a
prescription.
Some side effects may include:
-Dizziness, Drowsiness
-Headache
-Nausea, Vomiting
-Sweating

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HOW TO ALLEVIATE PAIN AFTER LEAVING THE
HOSPITAL
Pain usually doesnt stop until a couple of weeks after leaving the hospital. It is very
beneficial to know what you can do to alleviate your pain once you get home. In the
next couple of slides Ill be talking about how to alleviate a patients pain once they
have left the hospital. Ill be going over different methods and ways to alleviate the
pain.

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MEDICATION
It is VERY important that the patient takes the medication that is prescribed by the
doctor. After all it is prescribed to help deal with the pain they will feel after surgery.
It is important to follow the instructions on the label that tell the patient when and with
what to take the medication.
If that medication doesnt work they should contact the doctor to make sure that they
are allowed to take pain medications such as Tylenol, Excedrin, Aleve, etc.

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POSITION & COMFORTABILITY
Position is a HUGE key factor in how much pain a person can be in especially if you
have had a long surgery. If the patient is at home and they are uncomfortable its as
easy as adding another pillow under the area that underwent surgery.
If cold a patient can add an extra blanket for warmth or if hot take off a couple
off a couple of layers. If the patient cant sleep maybe try a different position like
laying on their back, side, or stomach which ever is most comfortable.

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RELAXING
Breathe, relax and sit back! Having just gone through surgery a patient should not
be doing anything over exhausting. Some ways to just lay back and relax can be as
simple as:
-Reading a Book
-Watching a Movie
-Listening to Music
-Taking Naps
Just whatever it is as long as the patient is not over doing themselves.
PRODUCT
For my product I chose to make a pamphlet like the type someone would get at a hospital. It displays
the last 3 slides on it which explain ways to alleviate your pain at home. I feel as though someone should
always have information on hand about what they are going through.
It also lists different websites you may use for help and reference to what to do about your pain.

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INSIDE
OUTSIDE
CONCLUSION
In conclusion, I have learned quite a bit at my mentorship site. I have learned how to
make a patient feel comfortable while they are in pain. The different medications
you are able to use depending on symptoms the patient may have. I learned the
many ways to show compassion and lend a helping hand to someone in pain. It has
been a big eye opener and I am lucky to have been a part of something I am so
passionate abouthelping others!

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 Now any
questions?
THANK YOU
I want to thank Mrs. Quinn for agreeing to be my mentor and actually taking time
out of your work day to teach me about what the PACU is all about, it was an
amazing learning experience.
I want to thank Mrs. Hart and Mrs. Click for allowing me to be in ISM it has been a
huge eye opener into what the medical field is really all about, and I have enjoyed it
greatly.
I would like to thank my parents for supporting me during this mentorship, they have
gone above and beyond to help be in this program.
Lastly, I would like to thank my evaluators and friends for coming out and watching
my presentation and to Alyssa for recording my presentation.

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WORKS CITED
Nauret, Rick. Fear of Pain After Surgery Can Stoke Anxiety. Psych Central News,
American Society of Anesthesiologists/ EurekAlert, 23 Oct. 2017,
psychcentral.com/news/2017/10/23/fear-of-pain-after-surgery-can-stoke-
anxiety/127806.html.
Relief for Pain After Surgery. Relief for Pain After Surgery, University of Pittsburg
Medical Center, 1 July 2012, www.upmc.com/patients-visitors/education/pain-
control/Pages/relief-for-pain-after-surgery.apsx.
What You Need to Know About Pain Control After Surgery. Cleveland Clinic,
Cleveland Clinic Foundation, 2 Oct. 2017,
my.clevelandclinic.org/health/articles/pain-control-after-surgery.
Zamosky, Lisa. Managing Pain After Surgery. WebMD, WebMD, 12 Mar. 2012,
www.webmd.com/pain-management/features/managing-pain-after-surgery#1.