Identify and state a priority nursing diagnosis label for your assigned patient related to pain.

A 60-year-old African American woman with metastatic ovarian cancer is experiencing chronic pain. Her pain ratings have been between 3 and 7 on the 0-10 numeric rating scale. Her vital signs remain within normal ranges. She is fully able to participate in her daily care. She describes herself as the matriarch of her family, and looks forward to daily visits from her family even when her pain rating is high. Her church pastor calls and visits her several times per week. She anticipates discharge in a few days.
1. Identify and state a priority nursing diagnosis label for your assigned patient related to pain.
2. Develop and state three (3) nursing interventions for this nursing diagnosis label or patient problem. When planning individualized nursing interventions, consider the patient’s type of pain and cultural perspective.
3. Provide your rationale or reasoning for each intervention chosen.
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Â� Â� Â� Â� Â� Â� Â� Â� Â� Â� Â� Â� Â� Â� Â� Everyone experiences pain at some point in their lives. Pain is not a pleasant feeling. As a nurse, we know that pain is individualized for each person. What one person describes as the worse pain that they have ever felt may not be as severe to another person experiencing the same type of discomfort. The American Pain Society defines pain as, “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (Hinkle & Cheever, 2014, pg. 213). Pain effects every age, gender, race, and socioeconomic status (Hinkle & Cheever, 2014). Experiencing pain can affect daily living. People who experience pain often times cannot function optimally while experiencing this pain. Pain can cause a great deal of other issues such as sleep loss, irritability, and immobility (Treas & Wilkinson, 2014). However, although many of us like to think of pain in a negative perspective, some forms of pain that we experience can be positive. Some pain can warn us of potential danger to the body, such as touching a hot object with your bare hands, and quickly withdrawing it because of the discomfort felt (Treas & Wilkinson, 2014). In order to manage pain effectively, we first need to know the origin and type of pain that is being dealt with.
Â� Â� Â� Â� Â� Â� Â� Â� Â� Â� Â� Â� Â� Â� Â� For the discussion for this week, I was given the scenario involving the 60 year old woman with chronic pain due to ovarian cancer that has metastasized. Chronic pain can defined as pain that has lasted 6 months or longer, and interferes with daily living (Treas & Wilkinson, 2014). It can be of cancer or noncancer origin, and can be time limited, or persist through the course of a person’s life (Hinkle & Cheever, 2014). The fact that the above patient is able to perform activities of daily living could mean that the pain that she is experiencing is tolerable. Her vitals appear stable at this time and this could also be a sign of well controlled pain at the moment. She is the matriarch of her family, and this could be a reason why, no matter how intense the pain is, she will still have her family visit. The fact that her pastor comes to visit several times a week means that she is spiritual. All of these variables could assist the nurse with developing a nursing diagnosis and caring for the patient. A priority nursing diagnosis that I could use for the patient would be as follows:
Diagnosis: Chronic pain related to cancer metastasis as evidenced by patient verbalizing pain as a 3 or 7 on 0-10 pain scale
Intervention: Assess for nonverbal signs of pain such as facial expressions, body posture, or guarding
Rationale: There are some times when the patient will deny their pain and state that pain is less than what it really is to avoid appearing “weak” to the physicians, nurses and even family (Treas & Wilkinson, 2014). Also, elderly patients will avoid admitting pain to avoid receiving pain medication due to the fear of becoming addicted. When the nurse pays attention to these nonverbal ques, they are able to evaluate pain further than what the patient is verbalizing. Common nonverbal signs of pain can be winching, facial grimacing, and clenching the jaw (Treas & Wilkinson, 2014).
Intervention: Provide nonpharmacological methods to relieve pain
Rationale: Nonpharmacological interventions are body based modalities, mind-body methods, biologically based therapies and energy therapies (Hinkle & Cheever, 2014). Some nonpharmacological methods to assist with pain are providing the patient with a massage or back rub, playing soft music to help the patient relax, and using distraction. Distraction can be used to take the patient’s mind off of the pain that is being experienced. Distraction can be visual, tactile, intellectual or auditory, and it helps the patient to only have a peripheral awareness of the pain (Treas & Wilkinson, 2014). This can reduce the amount of pain medication that the patient takes, but it should not be used to replace pharmacologic therapies (Hinkle & Cheever, 2014).
Intervention: Encourage the patient to pray or participate in spiritual practices pertaining to her beliefs or religion
Rationale: Due to the fact that the patient’s pastor comes to visit several times a week, it is clear that she is religious or spiritual. This should be incorporated into the patient’s plan of care because it may be important to the patient. Many religions that are practiced by African Americans believe that God is a healer, and praying for healing will promote wellness.
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Hinkle, J., & Cheever, K. (2014). Brunner and Suddarth’s textbook of medical-surgical nursing (13th ed.). Philadelphia, PA: Wolters Kluwer Health.
Ladwig, G., Ackley, B., & Makic, M. B. F. (2017). Mosby’s guide to nursing diagnosis (5th ed.). St. Louis, MO: Elsevier.
Treas, L. & Wilkinson, J. (2014). Basic nursing: Concepts, skills and reasoning. Philadelphia, PA: FA Davis.

1.Evaluate the discrepancy between the patient’s pain rating, behavioral signs of pain, and degree of participation in daily care/treatment for patient in each scenario
2.Explain a rationale for this discrepancy, using nursing knowledge and science
3.Compare and contrast the effectiveness of identified nursing interventions for assigned patient and peers’ patient. Also include your reasoning for this evaluation.
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