A nurse is reinforcing teaching about pain control with a client who has acute pain following a subtotal gastric resection.
Which of the following client statements indicates an understanding of pain control?

Choice A rationale:
Increasing pain over several hours is not a typical sign of a fentanyl patch overdose. Fentanyl is a potent opioid, and overdose symptoms often involve respiratory depression, altered mental status, and other serious issues. While it is possible for a patient to experience increased pain if the fentanyl patch is not providing adequate pain relief, this is not a specific sign of overdose.
Choice B rationale:
An itchy red rash on the skin is not a sign of a fentanyl patch overdose but can be associated with skin irritation or allergies to the adhesive in the patch. It's important to differentiate between a skin reaction and an overdose when evaluating patients using fentanyl patches. Overdose symptoms are more severe and life-threatening.
Choice C rationale:
Confusion and the inability to walk normally are characteristic signs of a fentanyl patch overdose. Fentanyl is a potent opioid, and overdose can lead to central nervous system depression, resulting in confusion, altered mental status, and difficulty with coordination and walking. These symptoms are serious and require immediate medical attention.
Choice D rationale:
Headache and nausea are not specific signs of a fentanyl patch overdose. While opioid overdose can cause various symptoms, such as respiratory depression and altered mental status, headache and nausea are not among the primary indicators. However, individual responses to medications can vary, and some patients may experience these symptoms as part of a broader set of overdose signs.

Choice A rationale:

Culture can influence a person's perception and expression of pain. It's important to consider cultural factors when assessing and managing pain because beliefs and attitudes about pain can vary significantly among different cultural groups. This can affect how pain is experienced and communicated.

Choice B rationale:

Psychological factors, such as anxiety, depression, and coping mechanisms, play a significant role in the experience of pain. Assessing psychological factors is essential for a comprehensive understanding of the patient's pain experience and developing appropriate pain management strategies.

Choice C rationale:

Understanding the patient's history of pain is crucial for a focused pain assessment. Previous experiences with pain, including the cause, intensity, and effectiveness of previous pain management strategies, can provide valuable insights into the current pain situation.

Choice D rationale:

Assessing contributing factors, such as concurrent medical conditions, injuries, or environmental factors, is essential to determine the underlying causes of pain and develop an effective pain management plan.

Choice E rationale:

Verbal indicators are essential for assessing pain. Patients often describe their pain in words, and understanding their descriptions and expressions of pain is fundamental to evaluating its intensity, location, quality, and duration.