Pain Management

Robert B. is a 67-year-old man who lives alone. He was active and had been walking every night except for the last 6 weeks when his knees began to bother him. He fell last week while trying to get to the bathroom. He hit his elbow, fractured his wrist, and bruised his ribs and knees. During your interview, he tells you this is not the first time he has fallen, but it is the first time he has injured himself. For the most part, Robert B. is healthy with exception of hypertension, enlarged prostate, mild diabetes controlled with oral medications, and some osteoarthritis in the knees. Robert B. states the pain is horrible and nothing seems to help. Every time he moves his arm, he could just pass out, it hurts so badly. He rates his pain intensity as a 10. Robert B. states, "You don't believe me." In addition, he reports with
movement the pain feels like a knife is stabbing him. He reports that his knees have been acting up recently, along with some numbness to his feet that seems worse at night. He reports stumbling at times. The doctor gave him some pain pills, but he states, "I'm afraid to take them because I don't want to be hooked on drugs." He reports not sleeping.

1.What type of pain does Robert B. have?

Does he have more than one?

2. Why is Robert B.'s new pain so severe?Is there anything in his current condition that 

would give an indication of why the pain intensity is so high?

3. How have Robert B.'s comorbidities affected his current pain complaint?

4. How has the chronic pain changed Robert B.'s ability to function?

5. List three potential lifestyle changes.