Nursing Diagnosis for Hypospadias (Postoperative) : Acute Pain
Hypospadias Definition :
Hypospadias is a developmental abnormalities of the anterior urethra where the estuary of ectopic urethra located on the ventral part of the penis proximal to the glans penis. Estuary of the urethra may also be located in the scrotum or perineum. The more proximal to the defect of the urethra, the penis will increasingly undergo shortening and forming curvature called "chordee".
The exact cause is not known with certainty. Some of the etiology of hypospadias have been proposed, including genetic factors, endocrine, and environmental factors. Approximately 28% of patients found their familial relationship. Genital tubercles enlargement and further development of the phallus and the urethra depends on testosterone levels during embryogenesis. If the testicles fail to produce testosterone or if the number of cells of the genital structure of the androgen receptor deficiency or not the formation of androgen-converting enzyme (5 alpha-reductase) then these are things that are thought to cause the occurrence of hypospadias.
Acute Pain Definition:
Emotional and sensory experience unpleasant arising from tissue damage in the actual and potential or show any damage (Association for the Study of Pain): sudden attacks or slowly from mild to severe intensity anticipated or predicted duration of pain less than 6 months.
Defining characteristics:
- Reported pain verbally and nonverbally.
- Show damage.
- Position to reduce pain.
- Agent injury (biology, psychology, chemistry, physics)
NOC
- Pain control.
- Level of Comfort.
- Pain level.
After nursing action for 2x24 hours the client is able to:
1. Controlling pain, with indicators:
- Being able to identify the causes.
- Able to report symptoms to health care.
- Being able to recognize the symptoms of pain.
- Unable to perform usual activities without pain.
- Able to report the presence of pain, pain frequency and duration of pain episodes.
- Vital signs returned to normal.
NIC
Pain Management
- Assess comprehensively about pain, include: location, characteristics and onset, duration, frequency, quality, intensity / severity of pain, and factors precipitation.
- Perform a comprehensive pain assessment starts from the location, characteristics, duration, frequency, quality, intensity and causes.
- Use therapeutic communication so that patients can express the pain experience and support in response to pain.
- Determine the impact of pain on daily life (sleep, appetite, activity, consciousness, mood, social relationships, work performance and conduct day-to-day responsibilities.
- Modification of pain control measures based on patient response.
- Improve sleep / rest.
Providing Analgesic
- Determining the location, characteristics, quality, and intensity of pain before treating clients.
- Check the history of drug allergy.
- Determine the type of analgesic used based on the type and level of pain.
- Determine a suitable analgesic, the optimal route of administration and dosage.
- Evaluating the effectiveness of analgesics at certain intervals, especially after the initial dose, the observations also do look for signs and symptoms of a bad or unfavorable (associated with respiratory depression, nausea, vomiting, dry mouth and constipation).
Collaboration
- Collaborate with the patient, the closest and other professionals to vote non-pharmacological techniques.
- Collaborate with your doctor if there is a change of drug, dose, route of administration, or intervals, and make specific recommendations based on the principle of equianalgesic.
Health Education
- Provide information about pain, such as: the cause, how long it occurred, and precautions.
- Instruct the patient to monitor own pain.