Step 4, Reflecting: Answer Questions # 3, and 5 using the reflecting step which can be more internal as students reflect

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Step 4, Reflecting: Answer Questions # 3, and 5 using the reflecting step which can be more internal as students reflect on their own assumptions, arguments, and rationales. Question 3: In answer to your assessment questions, Esperanza points to her right upper quadrant and states that the pain starts after she eats a heavy dinner but not every evening. The pain episodes began a month ago. She says the pain begins suddenly, lasts for 2 to 4 hours, and is a sharp "crampy ache." It does not radiate to other places but stays over her right upper quadrant. She says she has tried over-the-counter antacids, laxatives, and herbal remedies but none of these makes the pain better. She usually goes to bed with a heating pad until it subsides. She is unable to help her kids during these episodes because she must lie very still, and this upsets her. You ask her to rate her pain on a numeric scale with 0 being no pain and 10 being the worst pain. She says that at this time her pain is at a 2 but that during these episodes it is "above a 10." She also feels nauseated, sweaty, and weak during these painful episodes. Is she feeling acute pain or persistent pain? Explain. Question 5: Is Esperanza experiencing visceral pain, deep somatic pain, or cutaneous pain?
11:11 Case Study on Dizziness and Pain of Unknown Origin Mrs. J., a 78-year-old African American, has moved to an assisted living facility. She lived at home alone for the past 4 years since her husband's death. She enters this facility reluctantly but states, "I know my daughter can't take care of me right now her husband is ill and she has her hands full." Mrs. J. is in good health and takes one medication "for her blood pressure." During the last month she has been having "dizzy spells and has fallen twice. As you review her medication, she tells you that she started this blood pressure pill 4 weeks ago. She "hates running to the bathroom" so much. When you ask about her dizziness, she says, "I'm fine as long as I stay in bed or in my chair, but when I stand up I feel like I'm going to fall over! I get so light-headed." Instructions: Using Linda Caputi's Critical Thinking Model, in small groups, review the case study above on domestic and family violence. Select a scribe and write down your submissions below and each of you upload to Brightspace. Make sure and write your names and date at the top of your submission. Select a peer to submit. Step 1, Noticing: underline the key information in the case study using a highlighter. Upon completion, groups should explain their rationales for underlining. Step 2, Interpreting: For questions land 2 cluster the data underlined to identify information that is related in some way. Upon completion, groups should explain their clustering rationale. Question 1: As you begin to assess her vital signs, what assessment should you include? Question 2: When you check Mrs. J.'s vital signs, you find the following: Supine pulse: 68 beats per minute; supine blood pressure: 156/92 mm Hg. Standing pulse: 90 beats per minute; standing blood pressure: 110/86 mm Hg. She complains of slight dizziness and asks to sit down. Are these findings significant? If so, what is the cause?
11:13 Esperanza has been admitted to a medical-surgical unit with a chief complaint of "pain of unknown origin." She is 39 years old, married, has two teenage children, and works with her husband in their landscaping business. As you prepare for the admission assessment, her mother, who brought Esperanza to the hospital, tells you that they fear that Esperanza has "empacho." Esperanza agrees. During the assessment, you ask Esperanza to describe the pain in her own words. She begins to sob and says that she finds it hard to describe the pain. She says that she has given birth twice and that this pain is worse, but it only happens after she eats dinner and goes away after a few hours. She is not in severe pain at present but complains of a constant slight ache in her stomach. Step 3, Responding: The responding step is your rationale for correct and incorrect answers. Discuss rationales for the correct and incorrect answers for Question #1 and 2. Upon completion, groups should explain their rationales and discuss/debate as a larger group. Question 1: What questions should you ask as part of your pain assessment? Question 2: What tools are available to assist with pain assessment? Which one would you choose?