Post-

Operative
By: Lauren Hinojosa, HST Independent
Study Mentorship- 2nd semester, Spring
2019, Mrs. Click
Disclaimer
Some of my information is
taken from outside sources.
 Mentor

 My mentor is Rachel Beaman,

BSN, RN.
 She is a med-surg nurse at the
UTMB League City Campus.
 She studied nursing at UTMB
medical school
 She has her ACLS and BLS
 She worked as a vet tech before
she decided to enter nursing
 She worked at the Galveston
UTMB Family Medicine Unit from
2013-2016
Mentorship Site

 My mentorship site is
the UTMB League City
Campus Hospital, Med-
surg unit.
 The campus is
continuously
expanding, it now has
an M.D. Anderson
outpatient center.
 There are 20 med-surg
patient rooms.
 There are 10 operating
rooms.
HST Independent
Study Mentorship
 Independent Study Mentorship is
a collegiate level research
course.
 Students are expected to
research and present a project
pertaining to a field of work
they’re interested in.
 They are required to turn in
weekly journals and activity logs.
Why I Chose Post-
operative Pain
Management
 I chose the topic of post-
operative pain management
because it is something that
affects every patient.
 My mentor sees patients with
minimal discomfort as well as
patients whose pain is constant
and severe.
 I wanted to learn about different
types of treatment.

Tupungato. “Pain Management and Palliative Care Issues and Concepts.”

Www.12rf.Com, www.123rf.com/photo_26243003_pain-
management-and-palliative-care-issues-and-concepts-word-
cloud-illustration-word-collage-concept.html.
Key Point #1: Factors
contributing to pain

 Pain levels vary depending on

how invasive a surgery is
 Post-op pain can turn into
chronic pain if not properly
cared for.
 Some patients suffer from
stiffness, constipation, etc. as a
result of not being able to move
during recovery.
Key Point #2:
Mobility
 Physical therapy can help
alleviate soreness.
 Walking after surgery is good for
joint flexibility and posture.
 It also promotes blood
circulation.
 The risk of developing bed sores
is reduced when patients are
mobile after surgery.
Elderly Woman Using Walking Frame for Physical Mobility after Surgery
Accompanied in Hallway by Caring Medical Staff.
Key Point #3: Pain
Medication During
Recovery
 Morphine, Dilaudid, and
Fentanyl are the most common
narcotic pain relievers.
 However, they are usually only
used in cases of more severe
pain.
 Non-opioid drugs like Tylenol
can be used when a patient’s
pain is low (ex. 2-3 on a
numerical scale).
Key Point #4:
Tolerance
 Patients who experience
constant, severe pain can
develop a tolerance to powerful
medications like morphine.
 Dosage amounts for patients
like these must always be
double checked and approved
by the lead doctor.
 The amount prescribed to
patients like these could be
fatal to a non-tolerant patient.
Key Point #5:
Prevention of
Aggravating Factors
 Patient should be comfortable in
bed.
 Foam pads or pillows can be used
to make a patient more
comfortable.
 If patients can’t move or rest too
much pressure on a bony area,
bed sores can develop.
 You may have to assist them when
standing, walking, or even sitting
up.
 In some cases, an abdominal
binder can be put on a patient to
relieve pressure.

C., Steve. You Are Leaving Pain.

How Does Mobility Affect Post-Operative
Pain?
 Walking promotes
blood circulation,
which in turn prevents
clots.
 Increased blood flow
speeds up the healing
process of wounds and
incisions.
 Walking can decrease
pain from gas or
constipation.

After Incontinence Surgery: Recovering

in the Hospital.
Which Types of Pain Relievers are the
Most Effective?
 Opioids stimulate the
release of dopamine in
the brain, which
reduces discomfort.
 NSAIDs, short for
Nonsteroidal Anti-
Inflammatory Agents,
include over the
counter drugs such as
Advil and Ibuprofen.
 NSAIDs are used to
ease mild pain and
reduce dependency on
stronger medications.

Man Looking for Medication on Counter.

How do Pre-existing
Conditions Affect Treatment?

 In the case that a patient suffers from

chronic pain, they may develop a
tolerance to opioid medication.
 Therefore, it is very important that
the doctors on the floor are aware of
this.
 Patients with high opioid tolerance
can use a high-dosage Fentanyl patch
to reduce their discomfort.
Current Event
 Geisinger Health System
created a program called
ProvenRecovery which resulted
in an 18% decrease in opioid use
across the system’s hospitals.
 ProvenRecovery emphasizes
mobility, good nutrition, and
prescribing non-opioid
medication.
 This pilot program also led to
$1.5 million in cost savings in
neurosurgery and colon surgery
patients due to their shortened
hospital stays.
Kirby, Neal. Open bottle with pills spilling out. Times
Live, 15 June 2017,
www.timeslive.co.za/news/2017-06-15-a-
new-regulatory-br-regime-for-medicines-br-
comes-into-force-in-sa/
Artifact #1

 This artifact is a patient

information sheet.
 It shows the standard pain
assessment scale.
Artifact #2

 The Wong-Baker scale serves

to help evaluate a patient’s
pain.
 In most cases a number scale
(1-10) is used, but this scale is
often used in pediatrics.
 It can also be used for patients
that have limited cognitive
abilities.
Artifact #3

 This picture shows an example

of a transdermal medication.
 It is a sticker that can be
placed on a patient’s upper
body, arms, and back.
 The nurses always wear gloves
when putting this on a patient
so the medicine doesn’t
transfer from the patch to
their skin.
Artifact #4

 This image shows a

pain pump.
 Pain pumps are
preprogrammed, and
will shut off after max
dosage is reached.

“A PCA Pump Allows the Patient to Self-Administer Pain Management

Medication.” AESCULAP Implant Systems, bonesmart.org/oral-
intravenous-pain-medications/.
Artifact #5

 This artifact is a personal log

of notes I kept to myself.
 I wrote these because I
wanted to document some of
my more interesting
mentorship experiences.
 These were not part of my
weekly journals.
Artifact #6

 This artifact is a list I created

to keep track of new medical
terms I learned at mentorship.
Artifact #7

 This document tells patients

the risks of taking opioid
medications.
Artifact #8

 This graph shows the

relationship between pain
level and time it takes for
medication to become
effective.
Artifact #9

 These are the most

common pain assessment
scales offered to patients.
 The numerical scale is the
standard one used at my
mentorship site.

“Single-Dimensional Pain Scales.” PAIN BC, www.painbc.ca/health-

professionals/assessment-tools.
Artifact #10

 My final artifact shows

how a patient’s
discomfort can be
treated as their pain
worsens.

SickKids Staff. “The Three-Step Analgesic Ladder.”

Www.aboutkidshealth.ca,
www.aboutkidshealth.ca/Article?contentid=1075&lang
uage=English.
Product

 My product is a trifold board that

displays various pain assessment
scales.
 It also shows the criteria that
healthcare workers take into
consideration when evaluating a
patient’s discomfort.
  I now better understand how pain is controlled
in acute and long term recovery.

Conclusion  My mentorship experiences helped me learn

about different treatment options.
Weebly  https://springlaurenhinojosaism.weebl
y.com/
Portfolio
Thank You

 Thank you to Mrs. Click for

guiding me throughout the
semester.
 Thank you to my mentor,
Rachel, for letting me shadow
her and see the realities of her
work environment.
 Thank you to my parents, for
supporting me as I balanced
mentorship and school.
 Thank you to my evaluators, Mr.
Johnston and Mrs. Lynch, for
taking the time out of their
schedules to watch this
presentation.
Works Cited
Johnson, Steven Ross. “Geisinger Tackles Post-Op Pain Management without
Opiods.” Modern Healthcare, Modern Healthcare, 19 Nov. 2018,
www.modernhealthcare.com/article/20181116/NEWS/181119950.
Matthies, Kurt W.G. “Novel Research into Opioid Tolerance May Provide Future
Pain Relief with Lower Levels of Pain Medicine.” National Pain Report,
National Pain Report, 12 July 2016, nationalpainreport.com/novel-research-
into-opioid-tolerance-may-provide-future-pain-relief-with-lower-levels-of-
pain-medicine-8825755.html.
“Post-Op Pain: Management & Recovery After an Operation - When Seconds
Count.” When Seconds Count | Anesthesia, Pain Management & Surgery,
American Society of Anesthesiologists,
www.asahq.org/whensecondscount/pain-management/types-of-pain/post-
op/.
Works Cited
Garimella, Veerabhadram, and Christina Cellini. “Postoperative Pain Control.”
Clinics in Colon and Rectal Surgery, Thieme Medical Publishers, Sept. 2013,
www.ncbi.nlm.nih.gov/pmc/articles/PMC3747287/.
Admin, Oakbend Medical Center. “Why Is Ambulation Important to Recovery?”
Oakbend Medical Center, Oakbend Medical Center, 24 May 2018,
www.oakbendmedcenter.org/why-is-ambulation-important-to-recovery/.
“Oral and Intravenous Pain Medications.” BoneSmart®, The Foundation for the
Advancement of Research in Medicine, bonesmart.org/oral-intravenous-pain-
medications/.
“Fentanyl (Transdermal Route) Proper Use.” Mayo Clinic, Mayo Foundation for
Medical Education and Research, 1 Apr. 2019, www.mayoclinic.org/drugs-
supplements/fentanyl-transdermal-route/proper-use/drg-20068152.
Ogbru, Omudhome. “What Is an NSAID? Drug List, Names & Side Effects.”
MedicineNet,
www.medicinenet.com/nonsteroidal_antiinflammatory_drugs/article.htm#w
hat_are_nsaids_and_how_do_they_work.
Works Cited

“The Royal Children's Hospital Melbourne.” The Royal Children's Hospital

Melbourne,
www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Pain_Assessment_
and_Measurement/.
Nordqvist, Christian. “Bed Sores: Treatment, Stages, and Prevention.” Medical
News Today, MediLexicon International, 22 Dec. 2017,
www.medicalnewstoday.com/articles/173972.php.