- Is used when the patient’s verbal responses might be unreliable because of a dementia diagnosis.
- Assesses the patients breathing, vocalization, facial expression, body language, and consolability (0-2 each)
- The scale describes 0 as no pain and 10 as severe pain.
- PQRST – a pain scale but not for dementia patients
- P stands for provokes
- Q stands for quality
- R stands for radiates
- S stands for severity
- T stands for time.
- OLD CART stands for Onset, Location, Duration, Characteristics, Aggravating factors, Relieving factors, and Treatment.
- CHIPPS – pain scale for infants and children
Addiction: Compulsive use of a substance that occurs when it is used in a way other than intended. Patients have cravings when the substance is withdrawn, with an overriding inability to control their perceived need for the substance, even though there may be an awareness that the substance, or overuse of the substance, is harmful.
Dependence: A state in which the person feels that they can only function normally when using a specific substance. Abrupt withdrawal of the substance causes withdrawal symptoms.
Pseudoaddiction: The mistaken assumption that a patient who is seeking pain relief is addicted to a substance.
Tolerance: Occurs when the patient no longer has a therapeutic response to the drug and a higher dose is required to achieve the prior effectiveness.
In terms of substance abuse, dependence, or addiction, the substance can be defined as a prescribed drug, an illegal drug, alcohol, or a substance used in an unintended manner to produce mood or mind-altering effect. According to Mayerson and Julian (2017), Drug or substance addiction is a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. Very often, under the influences of substance/ drug addiction, the individuals are facing not only psychological but physiological consequences.
End-of-life uncomfortable signs and symptoms: Part 2 Cont.
Nurses frequently care for patients at the end of life. One of the challenges is managing end-of-life (EOL) symptoms such as dyspnea and pain. For patients nearing death, relieving distressing symptoms is perhaps the most valuable contribution you can make. Thus, the goal of patient care changes from cure to comfort.
End-of-life uncomfortable signs and symptoms: