The Complete Subjective Health Assessment
Pain Assessment-A Case Study
Overview
Case Study for Pain Assessment using the PQRSTU method. Identifies how to find objective and subjective cues for pain.
Case Study-Pain Assessment Part 1
1. B and E
2. A and C
3. A, C, and D
4. A
5. C
You have been assigned Mr. Edmund, who is a 30 year old patient who arrived in your facility yesterday following a motorvehicle accident. In the emergency department he was diagnosed with fractures of left ribs 6-8, left humorus fracture, and bilateral lung contusions. His arm was set and splinted in the emergency department last night. He has multiple bruises, abrasions and lacerations to his face, left arm, chest and abdomen. You review his most recent vital signs and note the following: R-26, P-110, B/P-140/86, Temp 36.8 C. Upon arrival in the room, you note Mr. Edumund is lying in bed with his eyes closed and is grimacing. He is lying very still and refuses to move. He tells you he is "very sore from the accident". You decide to use the PQRSTU assessment ( Lapum et al, 2019) to assess his pain and you note the following: respirations are shallow and about 26 per minute, radial pulse is strong and rapid at 112 bilaterally, L arm is in a splint, fingers are swollen and bruised but he reports sensation and is able to move them, lungs are clear bilaterally but diminished in the bases. Mr. Edmund is not on any oxygen and his oxygen saturation is 96%. He states he is unable to take a deep breath or cough. He states when he takes a deep breath he gets a immediate stabbing pain in his L side. He can not get comfortable and states nothing makes his pain any better. He states he hurts all over but his main concern is the severe pain in his left ribcage. He reports that as an 8 of 10 on the 0-10 numeric pain scale your facility uses. He states he has not had any pain medication since he left the emergency department last night.
1. Identify all of the following that are subjective assessments related to pain (more than one may be correct)
A. Oxygen Saturation of 96%
B. Reports when he takes a deep breath he gets an immediate stabbing pain
C. Bruising and abrasions on his face
D. Cast in place on his left arm
E. Reports pain of 8 out of 10 on the numeric scale
2. Identify all of the following that are objective assessments related to pain (more than 1 may be correct)
A. Respiratory Rate of 26
B. Reports when he takes a deep breath he gets an immediate stabbing pain
C. Facial Grimace
D. Splint in place on his left arm
E. Reports pain of 8 out of 10 on the numeric scale
3. Which of the following cues might indicate a patient is experiencing pain?
A. Facial Grimace
B. Pulse oximeter reading of 96%
C. Pulse rate of 112
D. Refusal to move
4. After getting Mr. Edmund pain medications, what would the prudent nurse focus on first to prevent further complications?
A. Having Mr. Edmund deep breath and cough and use a spirometer
B. Getting Mr. Edmund up to walk
C. Giving Mr. Edmund pain medication on a regular basis
D. Elevating Mr. Edmunds L arm to prevent swelling
5. Based on your assessment what is the primary nursing concern at this time?
A. Preventing swelling of Mr. Edmunds arm
B. Keeping Mr. Edmunds pain at a "0" rating
C. Preventing respiratory complications
D. Walking Mr. Edmund to the bathroom
Reference:
Lapum, J; St-Amant, O; Hughes, M; Petrie, P; Morrell, S; and Mistry, S. (2019). The Complete Subjective Health Assessment. eCampusOntario. https://ecampusontario.pressbooks.pub/healthassessment/part/preface/