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Health, Medicine, Nursing
Case Study
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Does the same pain rating apply to all? Discussion postings (Case Study Sample)

I am listing three discussion postings about the topic listed above and i need you to provide constructive and insightful comments that go beyond that of agree or disagree. 1)This is from Rachel A: The male patient that is post appendectomy is experiencing acute, visceral pain. The female patient with metastatic ovarian cancer and receiving chemotherapy is experiencing chronic pain. The factors that may play a role for the patients pain would be culture, religion and ethnicity. Some cultures, religions and ethnic backgrounds encourage people to remain stoic through dealing with pain while others encourage strong verbalization of the pain. Family, gender and age can also influence how a patient may deal with their pain. Some families believe that pain should be ignored and that the paerson should work through it where other families use pain as an attention seeking opportunity. Gender is also an important factor because boys are often taught that they should be tough and girls are taught to cry and express their pain because for them this is accepted and almost expected. Age is a factor because younger patients tend to complain more of pain. Younger patients typically have experienced less painful events than the older patients. The elderly sometimes view pain as an expected outcome because they deal with it on a daily basis and they sometimes consider it to be normal. The nurse would have to complete a thorough assessment with all of these factors in mind. The nurse would have to listen to what the patient states, observe their behavior, consider culture, ethnicity, and religious factors, and also to ask questions to gain as much information about the pain as possible. After the nurse has acquired the information needed, they would move forward with establishing the most effective and appropriate treatment for the pain. 2)This from Shana P: Everyone perceives pain differently especially between the genders. Pain is one of the body's most important communication tools. Your body uses pain to let you know that something is wrong. (Brunilda Nazario, MD, 2011) Uncontrolled pain is a common fear for many patients. Often pain is underestimated and not adequately treated or controlled by health care professionals. In order to ensure the patient's pain is adequately controlled the nurse needs to complete a comprehensive pain assessment. This assessment should include the patient describing the pain, describe what makes the pain better or worse, when does the pain occur and how often as well as the duration. Some other questions to ask the patient regarding their pain would be what other symptoms they experience when the pain is present and have the patient rate the pain on the appropriate pain scale. (Hunt, 2013) Something else the nurse needs to keep in mind while assessing the patient for pain is the patient's cultural background/beliefs, ethnicity, and religion. These factors can have a great impact on how the patient expresses their pain level. In the case of the twenty five year old male, he has probably never had any type of invasive procedure or any chronic pain issues so he does not know how to deal with this type of physical pain. His pain is caused by tissue damage as evidenced by having undergone an appendectomy and can be classified as psychogenic pain. Psychogenic pain usually has a physical origin; either tissue damage or nerve damage, but the pain caused by that damage is increased or prolonged by such factors as fear, depression, stress, or anxiety. (Brunilda Nazario, MD, 2011) Some of the physiologic factors that he is experiencing include increased pulse rate, nausea, and paleness. Other factors that may be influencing his pain level could be lack of family support and poor coping skills. There was no mention of family being present or visiting in the scenario. In the case of the sixty year old woman with ovarian cancer who has a history of chronic pain, her pain perception is completely different. This patient's pain perception may be different related to the fact that she has not had surgery recently and is undergoing chemotherapy. Even though chemotherapy can be physically demanding it is usually not an invasive procedure; although chemotherapy can produce nerve damage which in turn can cause shooting pain and numbness. The patient does rate her pain as 8/10, but she is still able to perform her ADL's and visit with her family without the pain interfering with her daily routine. Some factors that may be in evidence here is the fact that she has had chronic pain for thirty years and has an understanding of how to deal with or distract herself from the pain. Also with a good friend, family and/or religious support system in place this can help the patient recover faster and have a decreased level in pain as well as good outcomes in pain management. In current research it has been thought that women are less likely to allow pain to control their lives. Also women are more likely to marshal a variety of resources-coping skills, support, and distraction with which to deal with their pain. (Web MD, 2006) The RN needs to perform a comprehensive assessment as stated above as well as look for non-verbal pain indicators. Pain is a subjective and individual experience and should not be discounted by the nurse. Some interventions the RN can implement in the care of the patient experiencing pain include re-positioning, distraction, aroma therapy, massage, and pain medication as prescribed by the doctor. The patient needs to be included in the care plan for finding the most effective strategy to manage their pain. 3)This is from Crystal M: The 25 year old patient is experiencing acute pain r/t patient is one day post op appendectomy. The 60 year old woman is experiencing chronic pain. The 60 year old woman has a medical history of osteoarthritis for 30 years. Osteoarthritis is a common type of arthritis that affects the protective cartilage at the ends of bones. Osteoarthritis gradually worsens over time. The osteoarthritis causes chronic pain. According to the scenario, the 60 year old woman has a diagnosis metastatic ovarian cancer with chemotherapy. The patient doesn't mention pain associated with the cancer. Even though each patient pain level is the same a rating of 8 on 0-10 verbal pain scale the physiologic factors and s/s are different between the two patients. The 60 year old woman seems to be adaptive to her chronic osteoarthritis pain. This patient uses daily activity to distract herself of thinking about the pain. Her effective mindful technique of staying active with her daily tasks and visitation of family members assists this patient to manage the pain. It may be difficult for the nurse assess this patient for pain from an objective view. The nurse must just take the patient subjective verbal pain rating. In contrast, the nurse can objectively assess pain in the 25 year old patient. His vital signs have significantly changed from its normal state. The nurse can notice the patient mood and overall behavior has changed due to the pain. The nurse will also notice the patient is unable to move. The RN is responsible to assess the patient pain. Every patient perception of pain is different. The RN must use his/her nursing judgment to accurately evaluate the patient pain level. source..

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According to the posting, pain is not at all the same as it differs from an individual to the other. The factors that cause such pain are religion, culture and ethnicity. Some instances are cited where such factors in community dictate how someone should react during pain for instance, religion requiring an individual to endure pain till it is over or culture requiring a certain gender to behave in a way during pai...
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