A patient with terminal cancer describes a pain rating of 7 on a 0 to 10 scale. The nurse notes that the patient's vital signs are unchanged and recalls that vital signs may be elevated with pain. What is the best explanation for this?
a. The patient is not really in pain.
b. The patient has adapted to chronic pain.
c. The patient's vital signs are not responding because of the cancer.
d. Acute pain is not associated with elevated vital signs.
ANS: B
Because of the body's ability to adapt, patients with chronic nonmalignant pain or chronic cancer pain may not appear to be in pain. The physiological responses that accompany acute pain, such as elevated heart rate and blood pressure, cannot be sustained without harm to the body, so the body adapts, and the vital signs return to normal. If the patient says he or she is in pain, the patient must be believed.
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