Yolanda has osteoarthritis of the left knee for which she is receiving acetaminophen 1000mg every six hours. She rates her pain at a 4 every time you ask. What do you think an appropriate next step would be at this time?

Options for the question have not been provided. They are as follows:

Discuss increasing the acetaminophen to every four hours with the IDT.

Discuss adding an immediate-release opioid with the IDT.

Ask Yolanda what an acceptable pain score is for her.

Ask the IDT if Yolanda would benefit from an antidepressant for pain.

Ask Yolanda what an acceptable pain score is for her.

Explanation:

A pain scale is used sometimes in hospitals to mark the level of pain from 0 to 10. However, this scale is very subjective to use and might lead to erroneous results. Yolanda has been rating her pain at a 4 even after receiving a high dose of medication. In such a case, instead of jumping to conclusion regarding the drug dose or timing, it is better first to clearly understand the meaning of rating "4" according to her.

Many people who give a high rating to their pain level also say that its actually tolerable, which creates discrepancy. Hence, it is important to first confirm from Yolanda about her own acceptable score. "What score according to her is okay" and "what score requires immediate attention" are some of the questions that can be asked.