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Any registered nurses or nursing students out there familiar with the COLDERR mneumonic pain assessment help!?
I have to do this case and ask questions. But I don't know what to ask. Its hard and then I have to explain why I would ask that particular question.
Case Study:
Mike is an 8-year old boy brought into your small community hospital ER in Rural Town, USA by the paramedics. He was riding his bicycle on the street when hit by a car. The driver did not stop, but other motorists summoned the paramedics. Mike was not wearing a helmet. The paramedics have controlled the facial bleeding, Mike has facial and head trauma. It appears he has no fractures of the extremities. He is awake and semi-alert.
Prepare a PowerPoint presentation and include the following:
•What 8 questions would you ask this patient that would provide the most essential information to assist in your assessment:
I am not a nurse. However I do have a medical background and I have been teaching medical terminology, medical front office and billing and coding for six years. Obviously I have done a lot of presentations. I hope some of this helps and gives you some ideas. My personal experience and those of my students is that the most difficult part is starting.
I was not familiar with the mnemonic so I copied a flashcard:
http://flashcarddb.com/cardset/75014-test-3-208-flashcards
Character- sensation of the pain(sharp, aching, burning)
Onset-When did it start
Location-where does it hurt
Duration-constant vs. intermittent in nature
Exacerbation- factors that make it worse
Relief- what makes it better
Radiation- patter of shooting spreading or location of pain away from its origin
So I am going to give you a bunch of ideas. Integrate these with what you have already learned. Sorry if I give you some incorrect ideas.
My first thing is that the child is eight years old and so obviously you can't ask him what exacerbates his pain and get a good answer. LOL
I would tend to make it brief but tell it in a story like fashion in a soothing voice to keep him as calm as possible. I don't know whether or not these need to be done in order.
I don't know whether it would psychologically be appropriate to ask him if he remembers the accident and if he can tell me about it. However, I would ask if "it knocked him out" (he lost consciousness) at all. Some of these things the paramedics could possibly tell you but having been as the pain in some areas lessen, such as they dress the wounds on his face and they stop stinging as much, he may notice other pains he wasn't aware of before.
1) Onset. So, I understand you were riding your bike home from school and got hit by a car. When did you leave school? I don't think he'd know exactly what time he got hit.
2) Location. So where does it hurt? Can you point?
3) Character. So your head hurts. How does it hurt? Does it feel like a dull headache, sharp like someone is poking you with needles or does it sting like your face?
4) Duration. Does it hurt constantly or just on and off?
5) Exacerbation. Does anything make the pain worse? Like if you touch it?
6) Relief. An adult I would ask if anything relieves the pain. For a child I would ask does anything make the pain less, like if you close your eyes? (photosensitivity)
7) Radiation. A child wouldn't understand this either so I would just ask where else it hurts. Once you find out all the places he hurts ask if any of them just started only since he got here.
Hope at least some of this helps. Good luck
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