Question

A client informs the nurse that is having pleuritic pain. Before documenting this complaint, the nurse should verify whether the pain:

a) Worsens with deep breathing or coughing.

b) Is relieved by sitting upright.

c) Persists regardless of respiratory movements.

d) Indicates a muscle strain.

Answer 1

The nurse should confirm that the client's pleuritic pain worsens with actions like deep breathing or coughing since this is characteristic of pleuritic inflammation. Additionally, the concept of referred pain explains why diaphragmatic irritation can result in shoulder or neck pain.

Step-by-step explanation:

The nurse should verify whether the pain described by the client as pleuritic pain worsens with deep breathing or coughing. Pleuritic pain is a sharp, stabbing pain associated with the inflammation of the pleural tissue layers surrounding the lungs. This type of pain typically intensifies when the patient takes a deep breath, coughs, or suddenly moves, which can aggravate the inflamed pleural surfaces.

Referred pain is another important concept to consider when assessing a patient's pain. It is the conscious perception of visceral sensation projected to a different region of the body. For example, irritation to the diaphragm, a muscle situated between the thoracic and abdominal cavities, can cause pain that feels like it's in the shoulder or neck due to shared neural pathways. This phenomenon helps explain why some internal conditions may present with pain in unexpected, remote locations.