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NUR2447 Clinical Concepts

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Question 

Fred is alert and oriented, and answers questions appropriately.

Mobility: trunk movements are restricted, Fred demonstrates obvious distress on movement.

Chest: clear

Vital signs: BP: 130/80; P: 82; R: 16; temp: 37; SaO2: 97%

Fred complains of constant burning pain across his lower back with some tingling. Sometimes the pain also goes down his right leg and feels like an electric shock. On assessment the pain score is rated at 4/10, which Fred says never reduces below that level.  Occasionally the pain becomes more severe, up to a level of 10/10 and he is unable to move. Fred states that his activity level has been reduced to the point where he has difficulty walking further than about 500 metres.

When asked about his mood, Fred explains that he feels depressed about his situation. The constant pain causes mood fluctuations from day to day. These range from suicidal to anger, and he has a constant sense of frustration. The mood swings impact on his relationships with his family, and he is unable to concentrate on activities.

Section 1:  Part A:  

Discuss your assessment of Fred’s pain 

Include:

  • The initial general questions you would ask and observations about his behaviours
  • Four different relevantassessment tools you might utilise to assess the various elements and reflect the impact of the pain for Fred
  • Include your rationales for the assessment processes and tools used 

Part B: Type of Pain

What type of pain is Fred experiencing? Provide rationale/s for your answer.

Describe the physiological changes related to the pain that you might expect Fred to exhibit, providing rationales.

Section 2: Part A: Management Plan

Outline a plan of care that addresses Fred’s pain management. Your plan must reflect a patient centred approach (physical and psychosocial) to promote optimal outcomes. Include any therapies that may be appropriate for the type of pain he is experiencing. Do not include medications in this section.

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