Pt responds to noxious stimuli by withdrawal

Double-Helix, BSN, RN · Mar 12, 2013

What exactly is the patient doing?
My understanding of noxious stimuli is something unpleasant and the body automatically tries to pull away. What is a patient doing in withdrawal to a noxious stimuli... not pulling away??

Withdrawl is synonymous with pull away. If they are withdrawing from noxious stimuli, they are making an attempt to get away from it. Even if that attempt is not effective. This could be as simple as stiffening their arms and legs when something painful occurs.

itsdebraanne, ASN, RN · Mar 12, 2013

Withdrawl is synonymous with pull away. If they are withdrawing from noxious stimuli, they are making an attempt to get away from it. Even if that attempt is not effective. This could be as simple as stiffening their arms and legs when something painful occurs.

so for example, because a patient who is lethargic but responsive to verbal commands withdraws or "pulls away" from the noxious stimuli, it means that the client's condition is deteriorating? i thought pulling away from a stimuli is an appropriate response to pain (referring to the glasgow coma scale).

emerjensee · Mar 12, 2013

From my understanding,

Usually patients whose condition has deteriorated to where noxious stimuli would be used are no longer verbally responsive. If a patient is aware enough to respond verbally, they may be able to follow commands and move themselves even slightly..

-emerjensee

KelRN215, BSN, RN · Mar 12, 2013

so for example, because a patient who is lethargic but responsive to verbal commands withdraws or "pulls away" from the noxious stimuli, it means that the client's condition is deteriorating? i thought pulling away from a stimuli is an appropriate response to pain (referring to the glasgow coma scale).

If the patient is responsive to verbal commands, their motor score would be "6" for "obeys commands". A motor score of "4" for "withdraws to pain" means that is their best motor response and said patient would unlikely be responsive.

If a patient previously responded to verbal commands but now only withdraws to pain then yes, they are deteriorating.

itsdebraanne, ASN, RN · Mar 12, 2013

If a patient previously responded to verbal commands but now only withdraws to pain then yes, they are deteriorating.

that makes much more sense now. thank you!