1. The patient describes her pain as a “10” on a scale of 0 to 10, deep, occasionally cramping, and sharp or stabbing. She waves her hand over her chest and abdomen when asked topinpoint the location of the pain. How should the nurse document this assessment ofpain?

2. Discuss the impact of unrelieved pain on this patient and herfamily.

3. During a discussion with the pain resource nurse, it is suggested that the patient be given a Duragesic transdermal patch for pain management. She comments, “Oh, good! I know that will help make mypain go away quickly.” What is the best response to the patient’scomment?

4. After consideration of her history and her pain, the pain management specialist recommends patient-controlled analgesia (PCA); the PCA therapy is explained and an infusion is started with morphine as a basal infusion as well as interval self-dosing. What health teaching can you give to this patient?

5. Enlist any 2 nursing problems you identified in this patient?

6. The next morning while reviewing the infusion notes, the nurse sees that the patient dosed herself four times during the night. She is awake and states that her pain is now at a “5” and that she feels “a bit of relief now.” Later that afternoon during rounds after lunch, the nurse sees that she is asleep and has not touched her meal. Her respiratory rate is 12, but she does not answer immediately when the nurse calls her name. What is the priority nursing action? What additional actions should betaken?

7. During evening rounds, the patient is found to be unresponsive, with respiratory rate of 7 breaths/min. Her son, who was staying with her, said that he “pushed the button a fewtimes” while she was asleep because earlier “she said she was hurting but wouldn’t push it herself.” What would be the priority nursingactions?

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