HESI Case Study: Pain - Answered with Rationales During the nurse's initial interview, Natalie shares information about her home, career, and family. The
... [Show More] nurse evaluates the information to determine psychosocial factors that may impact pain management Pain Assessment (Title) What information obtained by the nurse is most likely to influence Natalie's perception of her pain? - Natalie's younger child is an infant who feeds every 3 hours -Natalie's 4-year-old enjoys being the "big brother" to his baby sister - Natalie was a first grade teacher before having children but now stays home -Natalie's parents live in the same neighborhood and often help with the children Rationale: Feeding an infant every 3 hours interrupts sleep and results in fatigue. Fatigue often heightens the perception of pain and impairs coping skills To assess the quality of Natalie's pain, the nurse asks which question? - "On a scale of 0 to 10, how would you rate your pain?" - "What word best describes the pain you are experiencing?" - "What actions do you take to relieve the pain?" - "What do you fear most about your pain?" Rationale: The quality of pain experienced is typically a descriptive term, such as burning, crushing, aching or stabbing. Which behavior that Natalie exhibits, that the nurse documents as objective signs of acute pain? - States pain level of 5 out of 10 - Complains of shortness of breath - Difficulty concentrating - Frequent grimacing Rationale: Grimacing is an objective indicator of pain. After completing the pain assessment, the nurse develops a plan of care. The nurse identifies pain and anxiety as the priority problems. Nursing Process (Title) To determine the etiology of Natalie's anxiety, what is the priority nursing intervention? - Refer the client to the clinic social worker - Continue the interview with the client - Review the healthcare provider's (HCP's) note -Recognize that pain causes anxiety Rationale: Further assessment by the nurse is needed to determine the cause of the client's anxiety. Which is the best goal for the nurse to include in the plan of care related to the problem statement of, "Acute pain related to strain [Show Less]