Brittany Lieber
January 10, 2018
NR 302
Case Study 2
Wrenda Fisher, a 35-year-old mother of two, visits the pain clinic of the regional medical center in her
community. Wrenda is interviewed by a certified pain management nurse. Her chief complaint is recent
onset back pain, which has limited her ability to care for her children. Initial assessment includes quality
of pain, factors that impact pain perception, and client behaviors such as guarding.
1. Provide five questions the nurse should ask Ms. Fisher to verify the characteristics of the pain
Where is your pain? The upper region of your back, middle, lower region? On the left or right?
Rationale: Pain may be localized or occur in multiple sites.
When did your pain start? What were you doing when it started? Is the pain constant or does it
come and go?
Rationale: Identifies onset and duration.
What does your pain feel like, is it burning, stabbing, aching, throbbing, fire-like, squeezing,
cramping, sharp, itching, tingling, shooting, crushing, sharp, or dull?
Rationale: Identifies quality of pain and helps differentiate between nociceptive and neuropathic
pain mechanisms.
Do you have pain right now? If so, how much?
Rationale: Identifies intensity.
What makes your pain better or worse?
Rationale: Identifies alleviating and aggravating factors.
2. What are some of the factors that could impact Ms. Fisher’s perception of pain?
Nerve disorders or any problems with the CNS and PNS.
Sensations may be felt elsewhere or not as strong or stronger due to malfunction of transmitters
relaying pain to the brain.
Example: Diabetic neuropathy.
Hyperalgesia: increased pain sensation
Allodynia: severe pain sensation that is evoked with a stimulus that does not normally induce
pain.
3. Give four possible behaviors Ms. Fisher may demonstrate because of her pain.
Ms. Fisher may be grimacing or moaning, indicating physical pain. She may clench her jaw with
movement due to pain.
Patient may become more stationary, (stillness) patient does not move and ambulate as much as
normal due to pain with movement. (diminished activity)
May demonstrate less than normal range of motion.
May demonstrate diaphoresis or change in vital signs.
This study source was downloaded by 100000882699655 from CourseHero.com on 03-24-2024 14:47:56 GMT -05:00
https://www.coursehero.com/file/32041351/NR-302-Case-Study-2-Lieberdocx/
January 10, 2018
NR 302
Case Study 2
Wrenda Fisher, a 35-year-old mother of two, visits the pain clinic of the regional medical center in her
community. Wrenda is interviewed by a certified pain management nurse. Her chief complaint is recent
onset back pain, which has limited her ability to care for her children. Initial assessment includes quality
of pain, factors that impact pain perception, and client behaviors such as guarding.
1. Provide five questions the nurse should ask Ms. Fisher to verify the characteristics of the pain
Where is your pain? The upper region of your back, middle, lower region? On the left or right?
Rationale: Pain may be localized or occur in multiple sites.
When did your pain start? What were you doing when it started? Is the pain constant or does it
come and go?
Rationale: Identifies onset and duration.
What does your pain feel like, is it burning, stabbing, aching, throbbing, fire-like, squeezing,
cramping, sharp, itching, tingling, shooting, crushing, sharp, or dull?
Rationale: Identifies quality of pain and helps differentiate between nociceptive and neuropathic
pain mechanisms.
Do you have pain right now? If so, how much?
Rationale: Identifies intensity.
What makes your pain better or worse?
Rationale: Identifies alleviating and aggravating factors.
2. What are some of the factors that could impact Ms. Fisher’s perception of pain?
Nerve disorders or any problems with the CNS and PNS.
Sensations may be felt elsewhere or not as strong or stronger due to malfunction of transmitters
relaying pain to the brain.
Example: Diabetic neuropathy.
Hyperalgesia: increased pain sensation
Allodynia: severe pain sensation that is evoked with a stimulus that does not normally induce
pain.
3. Give four possible behaviors Ms. Fisher may demonstrate because of her pain.
Ms. Fisher may be grimacing or moaning, indicating physical pain. She may clench her jaw with
movement due to pain.
Patient may become more stationary, (stillness) patient does not move and ambulate as much as
normal due to pain with movement. (diminished activity)
May demonstrate less than normal range of motion.
May demonstrate diaphoresis or change in vital signs.
This study source was downloaded by 100000882699655 from CourseHero.com on 03-24-2024 14:47:56 GMT -05:00
https://www.coursehero.com/file/32041351/NR-302-Case-Study-2-Lieberdocx/
