Case Study: Clinical Situation Patient A is a 27-year-old male who sustained a

Case Study: Clinical Situation
Patient A is a 27-year-old male who sustained a sprained left ankle 2 days ago after tripping and falling while playing basketball. Patient B is a 56-year-old female who is diagnosed with bone cancer and is admitted to the hospital for chemotherapy. Patient C is a 79-year-old female who had a right hip replacement 2 days ago. She continues to demonstrate disorientation to time and place as noted on admission to the hospital. However, the handoff report indicates that she showed signs of increased restlessness during the night and this morning.
Pertinent Terminology
Pain ___________________________________________________
Acute Pain ____________________________________________________
Chronic Pain ___________________________________________________
Breakthrough Pain ___________________________________________________
Cancer Pain ___________________________________________________
Pain Threshold ___________________________________________________
Pain Tolerance ___________________________________________________
Pain Assessment Tool ___________________________________________________
Unidimentional Pain Assessment Scales
Use a reference book to research and discuss Unidimensional Pain Assessment Scales. Select the most appropriate pain scale for the patients in the clinical situation.
For Patient A, the ____________________________ assessment scale is appropriate for the nurse to use.
For Patient B, the ____________________________ assessment scale is appropriate for the nurse to use.
For Patient C, the ____________________________ assessment scales are appropriate for the nurse to use.
Use the clinical situation and these follow-up assessments to make clinical decisions that focus on patient-centered care and pain management.
On assessing Patient A at 0800, the patient reports a pain level of 5. The swelling from the left ankle has remained the same since the injury. His pain medication is ordered every 4 hours and the last dose was given at 0415. The most appropriate follow-up is to ____________________________________________________________________________________________________________________________________________________________
On assessing Patient B at 0815, the patient reports a pain level of 9. The patient has a PCA with continuous morphine sulfate infusion. Morphine sulfate 3 mg is ordered every 2 hours IV push for breakthrough pain. It was last given at 0530. The most appropriate follow-up is to _____________________________________________________________________________
______________________________________________________________________________
On assessing Patient C at 0745, the nurse finds the patient restless, grabbing at her bed linens, and pulling on her right hip dressing. The nurse is unable to obtain a verbal pain level from the patient. The most appropriate follow-up is to ________________________________________
_____________________________________________________________________________
Read and evaluate the following statements. Decide whether the statement is True or False. For each statement, provide a rationale that supports your clinical decision.
Statement
True
False
Rationale
Changes in pulse, respirations, and blood pressure are strong indicators of the intensity of pain experienced by the patient.
Older adults report pain less often.
Self-report of pain level is the most reliable method to assess pain intensity.