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Student’s Name

Institutional Affiliation

Course

Date
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Analysis

Since the usual respiratory rate of a geriatric individual is between 16-25 every sixty

seconds, the recorded RR rate of 30 reveals the patient has a severe lower respiratory tract

infection, especially since tachypnoea is present. However, it is possible that the patient was

experiencing anxiety attacks that resulted in rapid breathing.

In this case, the administration of different opioids, PRN, regular hydromorphone, and

PRN antiemetics resulted in nausea (Du et al., 2019). Essentially, opioid-stimulated nausea

results from instant arousal on the chemoreceptor trigger zone, which perceives toxic substances

in the bloodstream and propels indications to the vomiting area located in the brain, which

instigates the vomit impulse. Additionally, the nauseated feeling is initiated via the instant

provocation of the vestibular apparatus and anticholinergic outcomes on the gastrointestinal

system (Tervonen et al., 2021). 

The patient recorded constipation for four days. Opioid peptides are located down the

digestive zone, revealing internal opiates discharged marginally may adjust gastrointestinal

movement and secretory actions. Moreover, most opiates contain a specific or principal mu

agonist movement that restrains gastric ability to move and impede gastric unload by acting

locally. Thus, the enhancement in GI locomotion and the gesticulation hindrance is linked with a

fortification of tonic shrinkages and limited propellant waves. Consequently, opioid-stimulated

constipation occurs.       

Conclusion

A single opiate should be administered to the patent for pain medication instead of

several little dosages of different opiates. Additionally, opioid rotation may be necessary to

contain the adverse effects of the drug (Prathivadi, Barton & Mazza, 2020). Moreover, if the pain
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is managed, but still the patient experiences adverse effects, reducing the dosage of medication

will steadily assist resolve the unfavorable outcomes while sustaining pain relief. Since the

patient has been constipated for four days from oral opioid administration, I would provide

Transdermal fentanyl for pain management (Al-Qurain et al., 2021). Besides, adding nonopioid

analgesics, using an adjuvant agent, and giving treatment to locate the body part where the pain

originates are alternatives for offering a synergistic approach to managing pain (Black-Tiong et

al., 2021).      

Nausea treatment requires the administration of serotonin antagonists to hinder its

release, mainly along the gastrointestinal tract. Administering these agents is essential in

preventing nausea from occurring due to postoperative illnesses (Conway et al., 2021). Besides,

ensuring the patient takes antipsychotic medication such as Haloperidol also treats nausea.

Action Plan

 If the pain persists, I will use hypnosis can assist in alleviating pain for the patient. To

reach this state of consciousness, the patient would need to relax the body the shift concentration

on a narrow range of items (Hibbert et al., 2021). Research shows various brain sections that deal

with pain perception can be influenced via hypnotic suggestion. 

Since pain is an intricate sensory and psychological occurrence, pain management for

geriatric patients should include psychological modalities. For instance, I would assist in

alleviating pain by asking the patient to relax and practice meditation to reduce anxiety levels.

For constipation, using prophylactic treatments will help in reversing the adverse effects of

opioid use (Veal et al., 2018). Besides, conservative treatment by enabling the patient to enhance
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present moment awareness by utilizing breathing techniques directed by imagery and other

methods to calm the mind and body would reduce pain (Veal et al., 2014). 

Functional restoration would also work, although it would require a multidisciplinary

effort. For instance, a health practitioner/ nursing team would specialize of to specialize in

treating the wrist and hip; a psychologist to assist the geriatric patient controlling stress levels

and develop coping mechanisms; an occupational therapist to enable the patient to improve daily

functions towards set objectives; a physical therapist to enhance body movement with joint

movement, education, stretching and body consciousness; a training and health instructor to

assist patients in preserving a healthy routine; and a rehabilitation counselor focusing on

professional concerns (Islam et al., 2018).

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References

Al-Qurain, A. A., Gebremichael, L. G., Khan, M. S., Williams, D. B., Mackenzie, L., Phillips,

C., ... & Wiese, M. D. (2021). Opioid prescribing and risk of drug-opioid interactions in

older discharged patients with polypharmacy in Australia. International Journal of

Clinical Pharmacy, 43(2), 365-374.

Black-Tiong, S., Gonzalez-Chica, D., & Stocks, N. (2021). Trends in long-term opioid

prescriptions for musculoskeletal conditions in Australian general practice: a national

longitudinal study using MedicineInsight, 2012–2018. BMJ Open, 11(4), e045418.

Conway, A., Valerio, H., Peacock, A., Degenhardt, L., Hayllar, J., Harrod, M. E., ... & ETHOS

Engage Study Group. (2021). Non-fatal opioid overdose, naloxone access, and naloxone

training among people who recently used opioids or received opioid agonist treatment in

Australia: The ETHOS Engage study. International Journal of Drug Policy, 96, 103421.

Du, W., Chong, S., McLachlan, A. J., Luo, L., Glasgow, N., & Gnjidic, D. (2019). Adverse drug

reactions due to opioid analgesic use in New South Wales, Australia: a spatial-temporal

analysis. BMC Pharmacology and Toxicology, 20(1), 1-11.

Hibbert, P. D., Clay‐Williams, R., Westbrook, J., Reed, R. L., Georgiou, A., Wiles, L. K., ... &

Braithwaite, J. (2021). Reducing preventable harm to residents in aged care: A systems

approach. Australasian Journal on Ageing, 40(1), 72-76.

Prathivadi, P., Barton, C., & Mazza, D. (2020). Qualitative insights into the opioid prescribing

practices of Australian GP. Family practice, 37(3), 412-417.

Islam, M. M., McRae, I. S., Mazumdar, S., Simpson, P., Wollersheim, D., Fatema, K., & Butler,

T. (2018). Prescription opioid dispensing in New South Wales, Australia: spatial and

temporal variation. BMC Pharmacology and Toxicology, 19(1), 1-9.

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Tervonen, H. E., Schaffer, A. L., Luckett, T., Phillips, J., Litchfield, M., Todd, A., & Pearson, S.

A. (2021). Patterns of opioid use in older people diagnosed with cancer in New South

Wales, Australia. Pharmacoepidemiology and Drug Safety, 30(3), 360-370.

Veal, F. C., Bereznicki, L. R., Thompson, A. J., & Peterson, G. M. (2014). Pharmacological

management of pain in Australian aged care facilities. Age and aging, 43(6), 851-856. 

Veal, F., Williams, M., Bereznicki, L., Cummings, E., Thompson, A., Peterson, G., &

Winzenberg, T. (2018). Barriers to optimal pain management in aged care facilities: an

Australian qualitative study. Pain Management Nursing, 19(2), 177-185.