Question

Wanda Frank, a 35-year-old mother of two, visits the pain clinic of the regional meeical center in her community. During Wanda's interview, she offers her chief complaint as recent onset of back pain, which has limited her ability to care for her children.

Which information obtained in the client history is most likely to influence Wanda's perception of her pain?

To assess the quality of Wanda's pain, the practical nurse (PN) asks which question?

Which behaviour exhibited by Wanda supports her subjective report of acite pain?

To determine the etiology of Wanda's anxiety, what is the priority nursing intervention?

What instructions should the PN provide?

Before implementing the interventions, what action is most important for the PN to take?

Answer 1

1)Wanda's inability to take care of her kids have resulted in influencing her perception of the pain.

2)Pain can be of various types depending on the site, type(acute or chronic, dull aching pain or sharp shooting pain) and triggering factors. Pain can also be classified as nosiceptive pain, that is, pain arising from tissue damage or inflammation, often times the trigger factor or the stimuli and the site of pain are in close proximation. or it could be Neuropathic pain where in the damage is to the nerves or spinal cord, which can be specifically located by making the patient do the movements which trigger the pain.

To assess the quality of Wanda's pain, the practical nurse can ask questions such as,

• if there has been a recent injury or fall which could have resulted in inflammation or tissue damage, there by producing the recent onset of back pain.
• The kind of physical activities that increase the intensity of the pain, such as holding the child, bending, lifting heavy objects.

3)As per the question, it seems to present that Wanda had in fact no physical evidence of inflammation or tissue damage, the subjective acute pain could have resulted from over working or fatigue.

4)Wanda's anxiety could have resulted from her inability to look after her kids, hence the priority nursing intervention at the moment would be to reassure the patient. Finding the etiology of the back pain would further require ordering a few tests such as MRI, CT scan etc, to completely rule out neuropathic pain.

If the back pain is due to weakness and fatigue, a proper diet plan should be provided to the patient. A complete blood work has to be performed to rule out Anaemia.

Women who are 35+ tend to have calcium deficiency, osteoporosis etc. tests have to be performed to rule out these factors as well