A patient asks the nurse why he felt pain prior to a myocardial infarction primarily in his left arm. How should the nurse respond?
1. "Pain in the arm related to cardiac tissue damage is a type of referred pain."
2. "Cardiac pain is generally unexplainable."
3. "Were you doing some physical activity with your arm just prior to the event?"
4. "What you are describing relates to psychogenic pain."
Correct Answer: 1
Referred pain is pain perceived in an area distant from the stimulus. Visceral sensory fibers synapse at the level of the spinal cord, close to fibers innervating other subcutaneous tissue areas of the body. Cardiac pain is explainable. Physical activity did not trigger the pain. Psychogenic pain occurs in the absence of a diagnosed physiological cause or event.
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