An unpleasant sensory experience caused by tissue damage is pain. Most people experience pain on some level throughout their lives. As a result of this onset of pain, the patient is reminded to seek assistance, support, and relief. Acute pain is classified as temporary, while chronic pain is permanent. Pain that has been present for less than six months is characterized as acute. Chronic pain, on the other hand, is defined as pain lasting longer than six months.
A pain treatment plan that includes assessment, diagnosis, a plan, goals, and interventions is shown below.
Symptoms and Signs of Pain
Several common symptoms and signs of pain can be identified.
- Self-reporting of pain intensity using standardized pain intensity scales, such as the visual analog scale, the Wong-Baker FACES scale, and the numeric rating scale
- An individual’s self-report of their pain characteristics includes;
- Burns, aches, pains, electric shock
- The presence of needles, shooting, sores, stabbing, or throbbing
Among the other signs are:
- Protective behaviour or guarding
- Painful facial expressions, such as grimaces
- Expressions of pain, such as restlessness, moaning, and crying
- An automatic response to pain, such as
- Sweating profusely
- Changes in BP, HR, RR
- Pupils dilated
A proxy may report pain and changes in behaviour or activity e.g. family members, caregivers
Pain management goals for patients
The following are some common goals and expectations for pain nursing care planning:
- The patient must demonstrate the use of suitable diversional activities and relaxation techniques
- According to the patient, a certain level of pain control is recommended. On a rating scale of 0 to 10, the score should be between 3 and 4.
- Patients show signs of improved well-being such as breathing, posture, relaxed muscle tone, and baseline pulse levels.
- Pharmacological and nonpharmacological pain-relief strategies are employed by the patient.
- Patients’ moods or coping abilities improve
Nursing Care Plan Diagnosis
Below is a list of diseases and medical conditions related to nursing diagnosis of pain;
- Surgery (Perioperative client)
- Fracture
- Brain tumour
- Tonsillitis
- Hypertension
Pain Nursing Assessment
A pain management plan needs to be developed based on an accurate assessment of pain by a nurse. Assessing pain is an important role for nurses, and they can employ the following methods:
- Perform a thorough assessment of the pain. Identify pain by analyzing its location, characteristics, quality, onset, duration, frequency, and severity. The most trustworthy source of information about pain is the patient experiencing it. Assess the pain level of the patient through an interview to plan an optimal pain management strategy. The nursing mnemonic “PQRST” can also be used during pain assessment:
- How do you deal with your pain? What makes it better or worse for you?
- What are the characteristics of the pain? Is it sharp, throbbing, dull, or stabbing?
- Location (region): “Let me know where your pain is.”
- If your patient has severe pain, ask them to rate it using a different method, like the pain scale of 1-10
- “Does it occur all the time, does it last a long time, does it come and go?”
- Ask the patient to point to the site where they feel discomfort to determine its location.
- Perform a history assessment of the pain. Obtain information about the effectiveness of previous pain management, medications taken, and any allergies or side effects associated with the medication.
- Establish the perception of pain in the patient.
- Every time vital signs are evaluated, the nurse should screen for pain.
- An assessment of pain should be initiated by the nurse
- To determine pain intensity, use the Wong-Baker FACEs Rating Scale
- Pain-related signs and symptoms should be investigated
- Assess the patient’s anticipation of pain relief
- Assess the patient’s willingness or ability to explore various pain-control methods.
- Identify factors that alleviate pain
- Identify pain management strategies and evaluate the patient’s response
- Assess the patient’s perception of the pain
Nursing Interventions for Pain
If you are a nurse, you should not evaluate whether or not the pain is real. No matter what, you should give the patient more attention. Following is a list of therapeutic nursing interventions for pain management:
- Measures should be taken to relieve pain before it becomes severe. An analgesic should be administered before the pain becomes severe or before it starts.
- Nursing must acknowledge and accept the patient’s pain by asking the patient about it. By undermining their pain reports, we are likely to create an unhealthy therapeutic relationship, which hinders pain management.
- Offering non-pharmacological pain management: Cognitive-behavioral, physical, and lifestyle pain management strategies can be used. There are cognitive-behavioural strategies such as distraction, guided imagery, and eliciting the relaxation response, as well as re-patterning unhelpful thinking. Among the physical interventions are massage, acupressure, heat and cold application, transcutaneous electrical nerve stimulation, and contralateral stimulation.
- As needed, prescribe pharmacologic pain management. Medications used for pain management include narcotics (opioids), non-opioids (NSAIDs), and co-analgesic drugs.
For moderate pain, opioid medications like tramadol, hydrocodone, and codeine are prescribed. For severe pain, opioids like morphine, oxycodone, fentanyl, hydromorphone, and methadone may be prescribed. Although analgesics are medications, they are not categorized as pain relievers. When combined with analgesics, they are highly effective at reducing pain.
- Multimodal pain management is the key to managing acute pain. An alternative to the use of opioids and other pain management techniques alone, this is a multimodal approach that involves using two or more distinct methods or drugs to enhance pain relief.
- If at all possible, analgesia should be administered before procedures that may cause pain. Examples include wound care, chest tube removal, venipunctures, and endotracheal suctioning.
- Nursing care should be provided during the peak period of analgesic effects. The peak effect of oral analgesics often occurs after 60 minutes, and of intravenous analgesics after 20 minutes. The effect of analgesics on patient comfort and compliance is therefore maximized when nursing tasks are performed at the peak of their effectiveness.
- Observe any signs and symptoms of side effects while evaluating the effectiveness of analgesics as ordered. Because pain medication is absorbed and metabolized differently by each patient, its effectiveness should be evaluated by them.
Nursing care plans for pain provide nurses with a systematic way to organize care for patients suffering from pain. Each step of the nursing care plan is based on scientific evidence and rationale, which is evidence-based nursing care. Can you write your nursing care plan for pain without having difficulty? There are professional nursing care plans that you can request for pain writing services.
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