Which has priority? Chronic pain or constipation?

[akruc353]

Which has priority? Chronic pain or constipation?

I am doing a care plan and I am wondering which one would be a priority for a patient who has chronic pain from herniated intervertebral disks, but is also constipated?

[applesxoranges, BSN, RN]

What was their admission? I know in the ER we don't do care plans like the floor but usually the more severe problem goes first. I would guess constipation is probably the more severe issue here.

[akruc353]

I was thinking constipation would be the first priority too. This is not an actual patient, just a case study for class. Thank you so much!!

[mrsboots87]

Pain. You need to stay on top of their pain as it can cause a physiological response that extends healing time for whatever they are there for. Constipation can be treated alongside pain treatment (and should be as pain meds cause constipation). But pain is a much higher priority then constipation. The patient cares more about their pain control then they do about their ability to poop.

[LeChien, BSN, RN]

Maybe their constipation is causing their pain..gotta analyze the source.

[Healthyme15]

Constipation is one of the best reason why we are suffering chronic pain. To relieve constipation as early as now, we have to take this Digestic by Mimonis which is intended to keep us away from any constipation that will threaten us.

[Tenebrae, BSN, RN]

When did they last pass a motion?

Is the consitpation ongoing, or something new? Are there any other symptoms present, eg nausea. Its why its important to look at a person as a whole being, not just one symptom in isolation

Chronic pain suggests that the pain has been present for sometime. A new case of constipation could be indicative of something a huge range of things, not just opioid induced constipation

[Lev, MSN, RN, NP]

Constipation is the priority over chronic pain. Constipation can lead to bowel obstruction and perforation or it can be a sign of bowel obstruction.

[direw0lf, BSN]

A kaplan question had a situation almost similar. A pt in acute paid vs constipation which med to give first, the answer was for pain. I asked too what if the pain is caused by constipation but the rationale was about addressing the client's pain first. It seems on most of these nclex questions you aren't supposed to over think but in real life...

[CFLA.RN]

There's a difference in acute pain vs chronic pain...I would treat acute pain first then the constipation. Chronic pain and constipation...would have to look at other factors, especially the site of chronic pain and the onset of the constipation.

[gelli.25]

I'd say constipation over chronic pain. Constipation can cause patient to bear down during BM, which can "potentially" worsen the herniated disk increasing the chronic pain. Also, constipation could be an acute issue such as a bowel obstruction. I guess you just have to look at the entire picture and details of the patient.