A patient with a history of chronic pain tells the nurse, "I do a variety of things to make my body produce its own pain reliever.". How should the nurse evaluate this statement?

Question

1. This is a common denial technique.
2. The patient is trying to appear to be a pain expert.
3. This statement offers the nurse a reason to reduce the amount of pain medication prescribed.
4. The patient is taking advantage of the body's ability to make endorphins.

Answer 1

4
Rationale 1: The patient did not deny the pain.
Rationale 2: The patient is an expert on his or her own pain. There is no evidence that this is the stimulus for this statement.
Rationale 3: There was no discussion of pain medication amounts.
Rationale 4: There is a pain inhibitory center within the dorsal horns of the spinal cord. The exact nature of this inhibitory mechanism is unknown. However, the most clearly defined chemical inhibitory mechanism is fueled by endorphins, which are naturally occurring opioid peptides in neurons in the brain, spinal cord, and gastrointestinal tract. Endorphins work by binding with opiate receptors on the neurons to inhibit pain impulse transmission.