Dying Process Death and Dying, Essay

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Deep tissue and bone pain typically need corticosteroids added to actually alleviate discomfort. Bisphosphonates may also be used when pain is not controlled by NSAIDs. When dealing with neuropathic pain, either continuous and constant burning sensations or sharp, stabbing and shooting pain, tricyclic antidepressants are often used, as well as local anesthetics depending on the severity and location. Most all of these do, however, have side-effects, and part of the nurse management paradigm is ensuring that the pain is managed but discomfort from other effects not magnified (McCaffrey and Pasero, 2000).

Unfortunately, the terminally ill often have special circumstances that require a specialized approach to pain management. Typically they have been on medications far longer, and are therefore subject to breakthrough pain or pain that is no longer manageable through standard doses or treatments, In this case, sustained release analgesics must be combined with immediate release at dosages about 25% of the original medication per hour until the pain is controlled (Miller, et.al.

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, 2001). Breakthroughs can also move to opioid tolerance, requiring rather complex rotations of medication.

Treating the terminally ill, particularly in the later stages of the illness, is difficult. The nurse must accurately assess the pain, wade through cognitive issues, and take a more holistic view of psychosocial and spiritual pain, and balance the needs of the patient with sound medical decisions that will not have a negative effect on their health that is not warranted based on their need to be kept comfortable.

REFERENCES

Kubler-Ross, E. (2005). On Grief and Grieving: Finding the meaning of Grief Through the Five Stages of Loss. New York: Simon and Schuster.

McCaffrey, M. And Pasero, C. (2000). Pain Management: The Nurse's Active Role in Opiod

Administration. New York: Lippincott Williams and Wilkins.

Miller, K., et.al. (2001). Challenges in Pain management at the End of Life. American Family

Physician. 64 (7): 1227-35.

St. Marie, B. (2009). Core Curriculum for….....

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