BSN 206 - Sherpath - Pain
Management NGN
Pt 1:
Client presents to the urgent care center and reports injuring left ankle while playing
basketball 2 days ago. Chief complaint: Pain in left ankle for 2 days duration.
Deep purple ecchymosis (bruising) 7 cm in diameter and 1+ edema noted along the
outer aspect of the left ankle.
Capillary refill on lower extremities is <2 seconds bilaterally
Skin is intact, warm, and dry.
Pedal pulses are 2+ bilaterally.
Client reports sharp pain in the left ankle and foot when moving foot or trying to walk.
Client demonstrates guarded movements of left ankle and is hesitant to put weight on
the left foot.
Tenderness of ankle upon palpation
Rates ankle pain a 7/10 pain scale.
No significant past medical history, no history of surgeries, and does not take any
routine medications.
States IBU 400 mg po q 8 hr since the time of injury - pain reduced to 5/10 pain scale
NKDA - answerActions to take:
1. Conduct a focused physical and neurological exam
2. Determine health literacy of the client
Center: Acute pain
Parameters to monitor:
1. Severity of pain
2. Provocation/initiating factors
Pt 2:
The client is a healthy 21-year-old male who weighs 165 lb (75 kg). He came to the
emergency department because he woke up this morning at 0300 with "excruciating"
generalized abdominal pain around his umbilicus (belly button). The pain has been
progressively worsening over the past several hours. The current time is 1500. He took
ibuprofen 400 mg by mouth at 1000, which initially decreased the pain some. The client
states that the pain has now gotten worse and is localized to his right lower quadrant
(RLQ). The pain increases with walking and movement. The client states that he feels
Management NGN
Pt 1:
Client presents to the urgent care center and reports injuring left ankle while playing
basketball 2 days ago. Chief complaint: Pain in left ankle for 2 days duration.
Deep purple ecchymosis (bruising) 7 cm in diameter and 1+ edema noted along the
outer aspect of the left ankle.
Capillary refill on lower extremities is <2 seconds bilaterally
Skin is intact, warm, and dry.
Pedal pulses are 2+ bilaterally.
Client reports sharp pain in the left ankle and foot when moving foot or trying to walk.
Client demonstrates guarded movements of left ankle and is hesitant to put weight on
the left foot.
Tenderness of ankle upon palpation
Rates ankle pain a 7/10 pain scale.
No significant past medical history, no history of surgeries, and does not take any
routine medications.
States IBU 400 mg po q 8 hr since the time of injury - pain reduced to 5/10 pain scale
NKDA - answerActions to take:
1. Conduct a focused physical and neurological exam
2. Determine health literacy of the client
Center: Acute pain
Parameters to monitor:
1. Severity of pain
2. Provocation/initiating factors
Pt 2:
The client is a healthy 21-year-old male who weighs 165 lb (75 kg). He came to the
emergency department because he woke up this morning at 0300 with "excruciating"
generalized abdominal pain around his umbilicus (belly button). The pain has been
progressively worsening over the past several hours. The current time is 1500. He took
ibuprofen 400 mg by mouth at 1000, which initially decreased the pain some. The client
states that the pain has now gotten worse and is localized to his right lower quadrant
(RLQ). The pain increases with walking and movement. The client states that he feels
