These assessment tools are used for patients who cannot verbally express their pain for various reasons: impaired mentation, mechanical intubation, language barriers, and other circumstances. The NIPS is used on infants to assess and treat pain. Severity (numeric pain scale 1 to 10) All these aspects allow for an individualized treatment plan. In addition, pain treatment can be more targeted the more information is known about the pain characteristics. Pain is often considered the fifth vital sign. Frequent assessment is necessary at designated times and as needed. Pain can change after procedures, activity, or other treatments such as wound dressing changes. Follow-up assessments are vital because it reveals if the treatment was effective or if adjustments to the care plan are necessary. Often pain cannot be eliminated. For example, after surgery, the patient can expect postoperative pain. The goal is to control pain as much as possible. Knowing about pain relief measures that worked in the past helps guide treatment in the future. Pain medication that the patient takes at home due to chronic pain needs to be taken into consideration. Someone that takes pain medicine daily has a different treatment plan for pain management than someone that does not have chronic pain from previous injury or health conditions. Accurate medication reconciliation helps prevent drug-drug interactions, dosage errors, and other adverse instances. Emotions, such as happiness and sadness but also pain, are expressed very differently in various cultures. Some cultures express pain very openly, and others do not. Therefore, frequent pain assessment and communication are key. Treating pain appropriately during the hospital stay facilitates the healing process. Administering pain medication before painful procedures or activities, such as exercise or dressing changes, helps reduce the pain during these activities and makes it more tolerable. Medications such as muscle relaxants or non-narcotic pain medication can be an effective addition to the existing treatment plan. These medications may be scheduled or PRN orders. It might seem as if it takes much longer to receive pain medication during painful episodes than it actually does. These feelings, alongside feelings of anxiety and fear, make the experience worse. Pain medication administration, therefore, should be a priority task. If the current ordered pain medication is not adequate, the physician may adjust analgesic treatment. Enough time between painful activities and procedures allows the patient to rest and recover for the next task. This system of sufficient recovery time after activities ensures appropriate pain control and may increase compliance. Opioid medications can cause nausea, pruritus, and constipation. Awareness may help counteract these side effects early by reporting symptoms and with preventative bowel stimulation and antiemetic treatment. Any patient on opioid medication is at risk for opioid-induced respiratory depression. To prevent these incidents, nurses are to use the Pasero-Opioid-Induced Sedation Scale (POSS). This tool is used to identify over sedation early. Visualization exercises help distract from painful sensations and focus on pleasant imagined ones. These techniques also help with distraction by concentrating on pleasant stimuli. These techniques are supposed to help the patient achieve a state of calm that will help reduce tensions and pain. Heat applications can help soothe and relax stiff muscles and joints, whereas cold compresses can numb and reduce inflammatory pain. Lying or sitting in the same position for a long time may cause tense muscles, stiff joints, and pain at pressure points. Changing positions helps relieve pressure and reduce pain. If dosage demands are frequent, the dosage might need to be adjusted to cover the patient’s pain. Signs of excessive sedation are respiratory depression and hemodynamic changes. Other complications are nausea and constipation. Taking pain medicine early prevents pain from becoming unbearable. However, it can be difficult to control pain once it becomes too intense. Consistent pain control helps with a steady recovery. For some patients, it might be the first time taking opioid analgesics. Having a reference on hand, especially after discharge, facilitates following medication regimens. Non-pharmacological pain relief can be used in addition to pharmacological pain relief for better pain control. Discouraging family members from pressing the button prevents unnecessary doses and reduces toxic effects from opioids. More Care Plans Impaired Skin Integrity Nursing Diagnosis & Care Plan Impaired Physical Mobility Nursing Diagnosis & Care Plan Head Injury Nursing Diagnosis & Care Plan Impaired Comfort Nursing Diagnosis & Care Plan Activity Intolerance Nursing Diagnosis & Care Plan References and Resources: https://www.mdcalc.com/nonverbal-pain-scale-nvps-nonverbal-patients https://www.mdcalc.com/behavioral-pain-scale-bps-pain-assessment-intubated-patients Potter, P., & Perry, A. (2013). Fundamentals of nursing (8th ed.). Elsevier. |