Pain is an unpleasant sensory experience occasioned by tissue injury. Everyone has experienced pain in one way or another in their life. The unexpected onset of pain reminds the patient to seek help in terms of support, assistance, and relief. Pain is classified into two categories; acute and chronic pain. Acute pain is pain that arises not more than 6 months of history. However, if the pain duration extends into more than 6 months, it falls under chronic pain.
Here is a care plan for pain that includes assessment, diagnosis, plan, goals, and interventions.
Signs and Symptoms of Pain
The following are the most common signs and symptoms of pain.
- Self-report of intensity using standardized pain intensity scales e.g visual analog scale, Wong-Baker FACES scale and numeric rating scale
- Self-report of pain characteristics such as;
- Burning, aching, pins, electric shock
- Needles, shooting, sore, stabbing, or throbbing
Other signs include:
- Guarding behavior or protecting
- Facial mask of pain e.g grimaces
- Expression of pain e.g restlessness, moaning crying
- Automatic response to pain such as
- Profuse sweating
- Alteration in BP, HR, RR
- Dilation of the pupils
Proxy reporting pain and behavior or activity change e.g caregivers, family members
Patient Goals for Pain
Here are some of the common nursing care planning goals and the expected outcome for pain:
- Patient to demonstrate the use of suitable diversional activities and relaxation skills
- The patient describes recommendable pain control at a level. For example, less than 3 to 4 on a rating scale of 0 to 10.
- The patient shows improved well-being such as respirations, body posture, relaxed muscle tone, or baseline levels for a pulse.
- The patient uses pharmacological and non-pharmacological pain-relief strategies.
- Patient displays improvement in mood or coping
Nursing Care Plan Diagnosis
The following are diseases, medical conditions related to pain nursing diagnosis;
- Surgery (Perioperative client)
- Brain tumor
Pain Nursing Assessment
Proper nursing assessment of pain is crucial for the development of an effective pain management plan. Nurses play a critical role in the assessment of pain, and they can use the following techniques to assess for pain:
- Perform a thorough assessment of pain. Determine through assessing the location, characteristics, quality, onset, duration, frequency, and severity of pain. The patient experiencing the pain serves as the most trusted source of information about their pain. As such, assess the pay by interviewing with the patient to help in planning for optimal pain management techniques. You can also perform a nursing mnemonic “PQRST” to guide you during pain assessment:
- Provoking factors: “What makes your pain better or worse?”
- Quality (Characteristics): “Tell me what it’s exactly like?. Is the pain sharp, throbbing, dull, or stabbing?”
- Region (location): “Show me where your pain is.”
- Severity: Ask your patient to rate pay by using a different pain rating method e.g Pain scale of 1-10
- Temporal (onset, duration, frequency): “Does it occur all the time or does it come and go?”
- Assess for the location of the pain by asking the patient to point to the site they feel discomfort.
- Perform history assessment of pain. Ask for the effectiveness of previous pain treatment or management, medication taken, and when allergies or known side effects of medication.
- Determine the patient’s perception of pain.
- Nurse to screen the pain every time vital signs are evaluated.
- Pain assessments should be initiated by the nurse
- Use the Wong-Baker FACEs Rating Scale to determine pain intensity
- Investigate signs and symptoms related to pain
- Determine the patient’s anticipation for pain relief
- Assess the patient’s willingness or ability to explore various techniques aimed at controlling pain.
- Determine factors that alleviate pain
- Evaluate the patient’s response to pain and management strategies
- Evaluate what the pain suggests to the patient
Nursing Interventions for Pain
As a nurse, you should not judge whether the pain is real or not. Regardless, you should take more time treating the patient. So, here are the therapeutic nursing interventions for your pain care plan:
- Provide measures to relieve pain before it becomes severe. Preferably provide an analgesic before the onset of pain or before it becomes severe if a larger dose is needed.
- Acknowledge and accept the patient’s pain: Nurses should ask patients about their pain and believe their report of pain. Undermining their pain reports may lead to an unhealthy therapeutic relationship, thus hindering pain management.
- Provide non-pharmacologic pain management: These may include cognitive-behavioral and physical strategies and lifestyle pain management. Cognitive-behavioral strategies include distraction, guide imagery, eliciting the relaxation response, and re-patterning unhelpful thinking. Physical interventions may include massage, acupressure, heat and cold application, transcutaneous electrical nerve stimulation, contralateral simulation, and immobilization.
- Provide pharmacologic pain management as required. Pain management by use of pharmacologic methods entails the use of opioids (narcotics), non-opioids (NSAIDs), and coanalgesic drugs.
Opioids include administering opioids such as tramadol, hydrocodone, codeine for moderate pain. Or opioids such as morphine, oxycodone, fentanyl, hydromorphone, and methadone for severe pain. Even though coanalgesics are medications, they are not categorized as pain medication. However, they are great at reducing pain when combined with analgesics.
- Manage acute pain using a multimodal approach. This is a multimodal approach based on the use of two or more distinct methods or drugs to enhance pain relief rather than using opioids and other pain management techniques alone.
- Administer analgesia before painful procedures whenever possible: This helps to prevent pain caused by relatively painful procedures such as wound care, chest tube removal, venipunctures, endotracheal suctioning, etc.
- Perform nursing care during the peak effects of analgesics. Oral analgesics often peak in 60 minutes and intravenous analgesics in 20 minutes. Therefore, performing nursing tasks at peak effect of analgesic maximizes patient comfort and compliance in care.
- Evaluate the effectiveness of analgesics as ordered and observe for any signs and symptoms of side effects. The effectiveness of pain mediation should be evaluated by the individual patient since they are absorbed and metabolized in different ways.
The nursing care plan for pain provides a systematic way of organizing efforts by nurses to deliver care for patients with pain. Each step in the nursing care plan is taken with scientific evidence and rationale that is evidence-based nursing care. So, are you facing difficulty writing your nursing care plan for pain? Well, you can ask for a professional nursing care plan for pain writing services.