You are the nurse in a pain clinic caring for an 88-year-old man who is suffering from long-term, intractable pain. At this point, the pain team feels that first-line pharmacological and nonpharmacological methods of pain relief have been ineffective

Question

What recommendation should guide this patient's subsequent care?
A) The patient may want to investigate new alternative pain management options that are outside the United States.
B) The patient may benefit from referral to a neurologist or neurosurgeon to discuss pain-management options.
C) The patient may want to increase his exercise and activities significantly to create distractions.
D) The patient may want to relocate to long-term care in order to have his ADL needs met.

Answer 1

Ans: B
Feedback:
In some situations, especially with long-term severe intractable pain, usual pharmacologic and nonpharmacologic methods of pain relief are ineffective. In those situations, neurologic and neurosurgical approaches to pain management may be considered. Investigating new alternative pain-management options that are outside the United States is unrealistic and may even be dangerous advice. Increasing his exercise and activities to create distractions is unrealistic when a patient is in intractable pain and this recommendation conveys the attitude that the pain is not real. Moving into a nursing home so others may care for him is an intervention that does not address the issue of pain.