Question

The nurse is performing a problem-focused assessment when the client reports pain in his left shoulder. Which of the following nursing questions has priority when determining the nature of the pain?

A. "Can you describe the characteristics of the pain, such as its onset, location, intensity, and any associated symptoms?"
B. "When did you first notice the pain in your left shoulder?"
C. "Have you taken any pain medication for your shoulder pain?"
D. "Are there any activities that seem to worsen or alleviate the pain in your left shoulder?"

Answer 1

The priority nursing question is to ask for detailed characteristics of the pain, as this provides a comprehensive assessment of the pain's nature. Shoulder pain may be associated with referred pain or represent true musculoskeletal issues, indicating the importance of a detailed assessment.

Step-by-step explanation:

When a nurse is performing a problem-focused assessment of a client reporting pain in his left shoulder, the priority question to determine the nature of the pain is "Can you describe the characteristics of the pain, such as its onset, location, intensity, and any associated symptoms?" This question is critical as it encompasses several key aspects of the pain experience which are essential for an accurate assessment. It allows the nurse to gather comprehensive information about the pain, which is crucial for developing an appropriate intervention plan.

Pain assessment is a complex task, and it's important to consider that shoulder pain can sometimes be referred pain, an example being Kehr's sign which indicates a rupture of the spleen with pain referred to the shoulder. It is also a hallmark of visceral pain from heart issues, where perceptions such as a heart attack may present as pain in the left shoulder. An understanding of somatic and visceral sensations, as well as the complex neurology behind referred pain, is intrinsic to a thorough assessment.