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Mr. C. Case Study Diana J. Wilkie, PhD, RN, FAAN

Mr. C. Case Study Diana J. Wilkie, PhD, RN, FAAN. Case Study: Mr. C.

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Mr. C. Case Study Diana J. Wilkie, PhD, RN, FAAN

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  1. Mr. C. Case Study Diana J. Wilkie, PhD, RN, FAAN

  2. Case Study: Mr. C • Mr. C. is an 80-year-old retired welder with a 10th grade education. He is widowed and has lived with his daughter and son-in-law for the past 9 months. Mr. C's daughter and son-in-law both work during the day and when they are not at home, Mr. C's granddaughter and great-granddaughter stay with him. Mr. C. likes to play poker with his family and friends. He also likes to do woodworking.

  3. Case Study: Mr. C Mr. C • Using a 0 to 10 scale, how much pain do you think Mr. C reported at the end of the videotape? • Where do you think Mr. C's pain was located? • What behaviors helped you to make these judgments? • Is Mr. C's pain physical or psychological?

  4. Case Study: Mr. C • Follow-up Discussion: • Mr. C. was healthy until diagnosed with stage four adenocarcinoma of the right apex of the lung one-year prior to the videotape. He received radiation therapy for four weeks. He took hydromorphone (Dilaudid) 2 mg 1 hour before the video. • His average pain was 4.4 on average but 3.3 after the time of the video but ranged up to 10 within seconds when he moved his spine in certain positions. • His pain was located in the R scapula area, R lower, mid back area and the 7th cervical dermatome of the R lower arm. • He engaged in 13 different pain control behaviors during the videotape session.

  5. Case Study: Mr. C • Follow-up Discussion: • Some of these behaviors included: Rubbing the R arm and hand, flexing and unflexing fingers of the R hand, flexing L knee when reclining, abducting and internally rotating R arm and holding it in fixed position during ambulation, and rubbing his back. • He described his pain as flickering, flashing, sharp, cramping, hot, itchy, tiring, exhausting, suffocating, fearful, blinding, miserable, cold, freezing, and nauseating. • This pain was continuous in nature but exacerbated with particular movements and positions.

  6. Case Study: Mr. C • Follow-up Discussion: • His McGill Pain Questionnaire scores were as follows: Sensory=11; Affective=7; Evaluative=3; Miscellaneous=5; Total=25; Number of Words Chosen=13. • His sensory score is average for people with cancer but his emotional score and other scores are high compared to other people with cancer. • Mr. C died one month after this video was made. He gave permission for the video to be used to teach doctors and nurses about pain. McGill Pain Questionnaire

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