Behavioral and cognitive therapy

Deeo breathing exercise

Reduce stress as muech as possible

Adivese to drink water

Investigate changes in character, location, or intensity of pain.

Pain Intensity or Rating Scales

The single most important indicator of the existence and intensity of pain is the client’s
report of pain. In practice, nurse tends tend to use less reliable measure for pain assessment as
changes in vital signs and observations of client’s behavior that they interpret as drug seeking
(D’Arcy,2011). Pain assessment that is not done accurately or completely leads to under treatment
of pain. The use of pain intensity scales is an easy and reliable method of determining the client’s
pain intensity. Such scales provide consistency for nurses to communicate with the client (adults
and children over the age 7) and other health care provider. To avoid confusion, numerical rating
scales (NRS) should use a 0-to-10 range with 0 indicating a no pain and 10 indicating the worst pain
possible for the individual. An 11 point (0-10) rating scale.

The inclusion of the word modifiers on the scale can assist some clients who find it difficult
to apply a number level to their pain. For example, after ruling out “0” and “10”, a nurse can ask
the client if it is mild (ratings in the 1-3 range), moderate (ratings in the range 4-6 range), or severe
(ratings in the 7-9 range).

Another way to evaluate the intensity of pain for the clients who are unable to use the
numeric rating scales is to determine the extent of pain awareness and degree of interference with
functioning. For example,

0=no pain

2=awareness of pain only when paying attention to it

4=can ignore pain and do things

6=cannot ignore pain, interferes with functioning

8=impairs ability to function or concentrate

10=intense incapacitating pain

IV Fluid therapy is essential when clients are unable to take sufficient food and fluids orally.
It is an efficient and effective method of supplying fluids directly into the intravascular fluid
compartment and replacing electrolyte losses. The primary care provider usually orders the IV fluid
therapy. The nurse is responsible for administering and maintaining the therapy and for teaching
the client and significant others how to continue the therapy at home if necessary.
COLOR CODE GAUGE LENGTH

Deep Green 18G 45

Pink 20G 33

Deep Blue 22G 25

Yellow 24G 19

PERFORMING BLADDER IRRIGATION

Purposes:
> To maintain the patency of a urinary catheter and tubing (closed continuous irrigation)

>To free a blockage in a urinary catheter or tubing (open intermittent irrigation)

Assessment: >Determine the client’s urinary

drainage system.

>Review the client record for recent intake and output and any difficulties the client has been
experiencing with the system. Review the results of previous irrigations > Assess the client for
any discomfort, bladder spasms, or distended abdomen.

HEMODIALYSIS
Theory of Hemodialysis

Hemodialysis, is the process whereby diffusion of dissolved particles occur from one
fluid compartment to another across a semi-permeable membrane. Four Basic functions of an
artificial kidney system:

1. Removal of the end product of protein metabolism.

2. Maintenance of a safe concentration of serum electrolytes

3. Correction of acidosis and replenishment of the blood’s buffer system

4. Removal of water.
Mechanism of solute transport:
A. Diffusion: is the movement of solutes by random molecular motion. Movement of particles from
an area of high concentration to an area of lower concentration.
Urine in ml/ weight of client in kg x hr