You are the nurse in a pain clinic caring for an 88-year-old man who is suffering from long-term severe intractable pain
At this point, the pain team feels that all pharmacologic and nonpharmacologic methods of pain relief have been ineffective. What recommendation could you make to this patient?
A) The patient may want to investigate new alternative pain management options that are outside the United States.
B) The patient may want to consult a neurologist or neurosurgeon to discuss pain-management options.
C) The patient may want to significantly increase his exercise and activities to create distractions.
D) The patient may want to move into a nursing home so others may care for him.
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. Pain resulting from malignancy (especially of the cervix, bladder, prostate, and lower bowel) may need special surgical and neurologic interventions. Option A is incorrect; investigating new alternative pain-management options that are outside the United States is unrealistic and may even be dangerous advice. Option C is incorrect; significantly increasing his exercise and activities to create distractions is unrealistic when a patient is in intractable pain and conveys the attitude that the pain is not real. Option D is incorrect; moving into a nursing home so others may care for him is an intervention that does not address the issue of pain.
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