A patient diagnosed with depression tells the nurse that his pain has been "unrelenting" over the last several weeks. What should the nurse consider as contributing to this patient's amount of pain?
1. Depression can cause an increase in pain sensations.
2. The pain medication has not been working.
3. Medication to treat the depression is interfering with the control of pain.
4. The patient is exaggerating the amount of pain.
Correct Answer: 1
Depression is clearly linked to pain. Serotonin, a neurotransmitter, is involved in the modulation of pain in the central nervous system. In clinically depressed people, serotonin is decreased, leading to an increase in pain sensations. The nurse has no way of knowing if the patient's pain medication is not controlling the pain. There is also no way of knowing if the medication used to treat the patient's depression is interfering with the control of pain. The nurse cannot make the assumption that the patient is exaggerating the amount of pain.
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