Which statement by the nurse is an example of back-channeling?

Choice A reason: This is incorrect. Chronic pain is not a type of pain, but a duration of pain. Chronic pain is pain that lasts longer than six months, regardless of the cause or location. It can affect the patient's physical and mental health, as well as their quality of life.

Choice B reason: This is incorrect. Psychogenic pain is not a type of pain, but a source of pain. Psychogenic pain is pain that is caused or influenced by psychological factors, such as stress, anxiety, depression, or trauma. It can affect any part of the body, but it is not related to the patient's heart attack.

Choice C reason: This is correct. Referred pain is pain that is felt in a different location from the actual source of pain. It occurs when the nerve fibers from different parts of the body converge in the spinal cord or brain. The patient's pain is down his left arm rather than in his chest because the heart and the arm share some nerve pathways.

Choice D reason: This is incorrect. Peripheral pain is pain that is caused by damage or dysfunction of the peripheral nervous system, which consists of the nerves outside the brain and spinal cord. It can cause sensations of numbness, tingling, burning, or shooting pain in the affected area. It is not related to the patient's heart attack.

Choice A reason: This is the correct choice because performing a focused patient assessment is the first action of the nurse when starting care for the patient at the beginning of the shift. A focused patient assessment involves collecting data about the patient's current condition, needs, and preferences. This data helps the nurse to identify any changes, problems, or risks that require immediate attention or intervention.

Choice B reason: This is an incorrect choice because conducting the patient’s health history is not the first action of the nurse when starting care for the patient at the beginning of the shift. A health history involves collecting data about the patient's past and present health status, medical history, family history, and social history. This data helps the nurse to understand the patient's background, risk factors, and health goals. A health history is usually conducted during the admission process or the initial assessment, not at the beginning of each shift.

Choice C reason: This is an incorrect choice because creating the nursing care plan for the patient is not the first action of the nurse when starting care for the patient at the beginning of the shift. A nursing care plan involves developing a set of interventions and outcomes based on the patient's assessment data, diagnosis, and goals. This plan guides the nurse to provide individualized and holistic care for the patient. A nursing care plan is usually created after the initial assessment and updated regularly throughout the care process, not at the beginning of each shift.

Choice D reason: This is an incorrect choice because administering prescribed medications is not the first action of the nurse when starting care for the patient at the beginning of the shift. Administering prescribed medications involves giving the patient the right drug, dose, route, time, and documentation according to the physician's order and the nursing standards. This action requires the nurse to check the patient's assessment data, allergies, vital signs, and laboratory results before giving the medication. Administering prescribed medications is usually done after performing a focused patient assessment, not before.