Fundamentals of Nursing Q 30
A client in a long-term care facility complains of pain. The nurse collects data about the client’s pain. The first step in pain assessment is for the nurse to
A. Have the client identify coping methods.
B. Get the description of the location and intensity of the pain.
C. Accept the client’s report of pain.
D. Determine the client’s status of pain.
Correct Answer: C. Accept the client’s report of pain.
Although all of the options above are correct, the first and most important piece of information in this client’s pain assessment is what the client is telling you about the pain –“the client’s report.” Pain is the most common complaint seen in a primary care office. There are over 50 million Americans, 20 percent of all patients, that suffer from chronic pain in the United States.
Option A: Effective treatment modalities for acute, chronic, centralized, or neuropathic are often different. Ten percent of the United States population complain of neuropathic pain. This population may benefit from a serotonin-norepinephrine reuptake inhibitor (SNRI) such as duloxetine, as compared to ibuprofen for an acute injury.
Option B: To fully assess the location of a patient’s pain, a body diagram map can be completed. Ankle sprains are solitary, acute injuries. Body diagrams may not be necessary in such a case. Localized pain is different from whole-body pain. Yet, in a patient with multiple comorbid pain disorders such as fibromyalgia, centralized pain disorder, and rheumatoid arthritis, distinguishing between the numerous locations of a patient’s pain, as well as factoring in the radiation of their pain, is difficult.
Option D: An essential first step in the pain assessment is distinguishing nociceptive pain from neuropathic. Pain characterized as burning, shooting, pins, and needles, or electric shock-like point the differential towards a neuropathic origin of the patient’s pain Sharp or throbbing pain is more likely to be acute nociceptive pain.