You are assessing an 86-year-old postoperative patient who has an unexpressive, stoic demeanor

Question

When you enter the room, the patient is curled into the fetal position and your assessment reveals that his vital signs are elevated and he is diaphoretic. You ask the patient what his pain level is on a 0-to-10 scale that you explained to the patient prior to surgery. The patient indicates a pain level of "three or so." You review your pain-management orders and find that all medications are ordered PRN. How would you treat this patient's pain?
A) Treat the patient on the basis of objective signs of pain and reassess him frequently.
B) Call the physician for new orders because it is apparent that the pain medicine is not working.
C) Believe what the patient says, reinforce education, and reassess often.
D) Ask the family what they think and treat the patient accordingly.

Answer 1

Ans: C
Feedback:
As always, the best guide to pain management and administration of analgesic agents in all patients, regardless of age, is what the individual patient says. However, further education and assessment are appropriate. You cannot usually treat pain the patient denies having if the orders are PRN only. The scenario does not indicate the present pain-management orders are not working for this patient. The family's insights do not override the patient's self-report.