Theories From the Biomedical Sciences

Hello This is my h.w instructions

associate what you have learned about theory in comparison to the case study and reflect on it.

 

·       A comparison of what you have learned from the case study to related theories you have studied. Make sure to cite these theories in APA format.

·       A comparison of the case study to your nursing practice, giving one or two examples from your nursing experience in which you might have applied a particular theory covered.

Your reflection should be a minimum of five to six paragraphs

Below are the theories

CHAPTER 15: Theories From the Biomedical Sciences

Melanie McEwen

Maria Leon is in her final year of a graduate program preparing to become a certified registered nurse anesthetist (CRNA). During the course of her graduate education, Maria observed that most people reported a burning sensation as propofol (a drug used to induce general anesthesia) was administered intravenously (IV). In conducting a review of the literature and discussing her observations with other CRNAs, Maria found several techniques used to minimize the injection pain. Based on this information, Maria decided that she would like to conduct a research study to examine the effectiveness of using lidocaine to reduce the injection pain of propofol. This project would fulfill the capstone requirement for her master’s degree.

A literature review of pain management led Maria to the gate control theory, which posits that there is a gating mechanism in the spinal cord. When pain impulses are transmitted from the periphery of the body by nerve fibers, the impulses travel to the dorsal horns of the spinal cord, specifically to the area of the cord called the substantia gelatinosa. According to the theory, when the gate is open, pain impulses ascend to the brain; when the gate is partially open, only some of the pain impulses can pass through. Pain medication has an effect on the gate, and if pain medication is administered before the onset of pain, it will help keep the gate closed, allowing fewer pain impulses to pass through.

In planning her research project, Maria used the gate control theory to guide the design and structure of the study. For the study, she decided to compare two techniques for pain prevention. One technique involved mixing 20 ml of a 1% propofol solution with 5 ml of a 2% lidocaine solution and injecting 1 ml of the mixture immediately before administration of the propofol. The second technique involved the placement of a tourniquet inflated to 50 mmHg on the arm in which the IV access device was placed. Then, 5 ml of 2% lidocaine would be injected and the tourniquet would be removed 1 minute later; propofol would then be injected. A time frame of 20 seconds would allow the clients to report pain in the arm before the propofol took effect. Maria also planned to have a control group that did not have either of the pain prevention interventions.

If the theory was correct, Maria hypothesized that both experimental groups would have less pain from the injection because the gate that allowed pain sensations would not open or would only partially open. She did not know which of the two experimental procedures would be more effective in preventing pain but was enthusiastic about conducting the study and adding to the body of knowledge on pain prevention in anesthesia.