A patient tells the nurse that his back has not "bothered" him for months but now that he's in the intensive care unit, his back is "killing" him
The nurse realizes the reason for this increase in pain can be because of 1. forced immobility and anxiety.
2. exacerbation of a long-standing back problem.
3. the disease process that caused the hospital admission.
4. a tolerance to pain medication.
1
Rationale: Forced immobility because of the serious or critical nature of an illness and attachment to multiple tubes may exacerbate more chronic conditions, such as back or arthritic pain. Acute pain is usually accompanied by some degree of anxiety, which may be further aggravated by the stress associated with the hospital or critical care environment. High-anxiety states are associated with an increase in pain perception and may decrease pain tolerance. There is no evidence to suggest that the patient's back problem is being exacerbated or it is because of the disease process that caused the hospital admission. There is also no evidence to suggest the patient has a tolerance to pain medication.
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