Question

An older adult client with significant cognitive impairment has been hospitalized for surgery. To assess for pain postoperatively, what is the nurse's best approach

Answer 1

The patient's prescription and over-the-counter drugs should be reviewed.

The nurse's best approach to an older adult client with significant cognitive impairment has been hospitalized for surgery  to assess for pain postoperatively is by reviewing the patient's prescription and over-the-counter drugs.

• Think about any that might be causing cognitive problems.

• Consider whether anticholinergics, antihistamines, opioids, sedatives, and benzodiazepines are still necessary.
• To prevent undertreatment and overdosing, consider whether the patient takes their meds as directed, if a pill organizer is being utilized, and if a caregiver monitors medication intake.

• Be aware that pharmacological treatment results are often modest and may be accompanied by negative side effects.

• Analyze any behavioral issues.

• Check to see if a more controlled environment or other non-pharmacological methods could take the place of or postpone the use of antipsychotic drugs.

• Any off-label use of antipsychotic drugs in dementia patients should be done with extreme caution, and effectiveness and safety should be constantly monitored.
• If new medication is prescribed, schedule a follow-up session within a set duration (for example, 4 to 6 weeks). Since diminished self-awareness of cognitive decline is prevalent and reliable information transfer is more likely with the presence of a care partner, ask the patient to bring a family member or friend to every appointment who may serve as a care partner.

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