Case Study #2 - Vague complaints of pain in the Emergency Department
Susan M. Hewitt RN, CEN The Robert B. Miller College
BSRN-340-Pharmacology for Nursing Care
Instructor: Mr. James Middleton
February 26th, 2009
Case Study #2 – Vague complaints of pain in the Emergency Department Many people that come to the emergency department who complain of pain are usually vague about their symptoms. Other people over-react and could win an Oscar nomination for their pain presentation. People who come in with vague complaints of pain are often puzzled and sometimes very non-specific to the area that hurts them. I came across an article in the Journal of Emergency Nursing about a man who complained of vague back pain. In this article, a 49-year-old man presented to the emergency department complaining of non-specific, aching, low back pain that he rated a 7 on a 0-10 scale. His discomfort began that morning after he bent over to pick something off the floor. The pain did not radiate and intensified with prolonged periods of standing still. The patient denied any weakness or paresthesia of the lower extremities and had no urinary complaints. “His respirations were slightly labored, but the man denied chest pain or shortness of breath. However, he was hypertensive (blood pressure 158/100), and febrile (temperature, 38.5C / 101.3F). The triage nurse assigned him a non-urgent acuity rating and placed him in the waiting room, where he waited for approximately 5 minutes.” (Jeremy Johnson, 2008). The man’s medical history was pretty normal but he had a long history of hypertension and recent history of an upper respiratory infection. According to (Jeremy Johnson, 2008), “Physical examination was positive for mild tendereness to palpation over the mid thoracic area of his back. Auscultation of heart and lung fields revealed no murmurs, gallops, or rubs and no
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