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Pathology of Disease: Describe the pathology related to your patients medical diagnosis. Include textbook signs and symptoms
My patient is experiencing acute, intractable pain of an unknown cause. Acute pain results from acute injury, disease, tissue ischemia,
muscle spasm, or surgery. My patient had deep somatic pain of bone, muscle blood vessels, and connective tissues. Acute pain serves a
biologic purpose, because it acts as a warning signal. It activates the sympathetic nervous system into various physiologic responses such
as: increased heart rate, increased blood pressure, increased respiratory rate, dilated pupils and, sweating. Behavioral signs of acute pain
may include restlessness, an inability to concentrate, apprehension, and overall distress. Acute pain is usually temporary, of sudden onset,
and easily localized. The patient can usually describe the type of pain, and it normally confines itself to a certain area of the body.
Although possibly severe, acute pain is limited over time and generally can be managed successfully. The gate control theory concludes
that there is a strong relationship between behavioral and emotional responses to pain. According to this theory, a gating mechanism
occurs in the spinal cord. Nerve fibers (A delta and C fibers) transmit pain impulses from the periphery of the body traveling to the dorsal
horn of the spinal cord, specifically to the substantia gelatinosa. The cells of the substantia gelatinosa can inhibit or facilitate the pain
impulses transmitted to the trigger (T cells) cells. When T cell activity is inhibited, the gate is closed and impulses are less likely to be
transmitted to the brain. When the gate is opened, pain impulses ascend to the brain. A wide range of sensory input is capable of
producing pain. Signs and symptoms of acute pain include: Verbal or coded report of pain by observed evidence, protective gestures,
guarded behavior, facial mask, sleep disturbances, beaten look, grimace. Self focus or narrowed focus such as altered time perception,
impaired thought processes, reduced interaction with people and environment. Distraction behavior such as pacing, seeking our other
people or activities, repetitive activities. An autonomic change in muscle tone which may span from listless to rigid. Autonomic
physiologic responses to pain such as: diaphoresis, changes in blood pressure, respiration, pulse, and pupillary dilation. Patient may
exhibit expressive behavior such as: restlessness, moaning, crying, vigilance, irritability, and sighing. Often a person in pain has a change
in appetite and eating.
How does your client compare to what is considered usual medical/nursing interventions?