A client’s postoperative pain seems to be getting worse instead of better. When the nurse asks the client, “Why do you think it’s getting worse?” the…

Pain is a multidimensional experience influenced by biological, psychological, and emotional factors. Psychological distress, such as acute grief following the death of a spouse, can significantly lower a client's pain threshold and intensify physical pain perception. The practical nurse recognizes that physical symptoms may be exacerbated by emotional trauma. Rather than immediately increasing pharmacological interventions or requesting a psychiatric consultation for a normal grief reaction, the nurse should incorporate care plan strategies focused on addressing grief and loss. Developing targeted interventions for grief helps the client process loss, improves coping mechanisms, and ultimately assists in managing the client's perception of postoperative pain.

Option A: Increasing medication addresses only physical sensations without addressing the underlying emotional grief driving the increased perception of pain, risking oversedation or toxicity.

Option B: Administering sedatives masks emotional distress rather than addressing the client's underlying grief process and does not resolve the root cause of the distress.

Option C: Acute grief is a natural reaction to bereavement; referring to psychiatry is premature before the nurse implements basic supportive nursing interventions for loss.

1. NCSBN. (2023). NCLEX-PN Test Plan: Psychosocial Integrity & Basic Care and Comfort. National Council of State Boards of Nursing. Section 3.2, pp. 18–22.

2. Moderate-to-Severe Pain Management Guidelines. University of Iowa Health Care Nursing Clinical Practice Manual, Section 4: Non-pharmacological and Psychosocial Pain Interventions, pp. 45–48.

3. Psychological Influences on Pain Perception. Journal of Pain Research, 14, 1205–1215. https://doi.org/10.2147/JPR.S293300