Care Plan: Nursing Interventions for Acute Pain, NANDA
Advice on Implementation of Nursing Interventions for acute pain
In the acute care settings such as medical, surgical, pediatrics, or labor and delivery, you will come across all kinds of people that are in acute pain for many different reasons. You will only get to impart 12 hours, maybe 15 hours after charting is done, of your care as a nurse into the life of the patient. You must realize that you will be working together with other nurses that are on different shifts and even work different days then you. Your patient may have a three-day stay in the hospital and have five different nurses take care of them. All of those nurses should be trying to control the acute pain. Most nursing interventions are collaborative, which means it is going to take more than one person in order to effectively complete the nursing intervention. When you receive report at the beginning of your shift the first thing you should do is go establish contact with your patients and determine which ones are having pain and need intervention at that very moment. It is unrealistic to assume that because you just got on shift, that nobody is due for pain intervention.
Nursing interventions for acute pain are important because most of the time a patient in acute pain is not used to being in pain. Acute pain by definition is anything less than six months. If you are a nurse that works on the surgical floor, you are going to have a lot of patients that have acute pain. Whether they are about to have surgery due to some type of trauma, or they just got out of surgery and are experiencing pain due to the surgery. The NANDA definition of pain states that pain is whatever the person says the pain is. As a nurse we are not to judge whether the acute pain is real or not. As a nurse we should spend more time treating patients. Acute pain can be a physical and emotional experience that arises due to some type of trauma.
Acute pain can happen for many reasons. Obviously, you the nurse should first determine whether the pain is acute or not. If this pain is something that someone has been living with for more than six months the pain is considered chronic. Nursing interventions for chronic pain are slightly different. Patients with chronic pain can developed certain internal coping mechanisms to help them deal with the pain. During your assessment as you gather data to help you select the nursing diagnosis of acute pain, you may come across some of these characteristics that your patient has told you about the acute pain they are experiencing. The patient should have the ability to speak in order to report their pain on a scale of 0 to 10. If the patient cannot speak they should be able to point to pain rating scale in order to rate their pain.
Remember, pain is always subjective(what the patient says) the pain cannot be proved or disproved. A patient's report of acute pain is the best indicator of that pain. It is important to establish a goal of where on the scale you and your patient should keep that pain at in order for the patient to comfortably get the things done to get better For example, after surgery patients required to roll over in their beds, deep breathe to prevent pneumonia, and most importantly to begin walking around to promote bowel function. It is very important that you ask your patient every time if they are in pain. Do not just observe and assume because their face doesn't look like they're not in pain then they must be okay. Never say, "it doesn't look like my patient is in pain, so they must not be." Behavior in vital signs can never substitute what the patient says the acute pain. To clarify, I did not say that vital signs don't show pain, I said you can't substitute vital signs over the patient's report of pain. However, as a nurse there are observable response to pain by the patient that you can use in order to assess acute pain properly. Visible signs that your patient is having acute pain are a loss of appetite, inability to deep breathe, walk, sleep, or form activities of daily living. Patients may be guarded about allowing you to touch them, especially in the area that is hurting. Patients may try to distract themselves from the pain by crying or even laughing.
The goals of nursing interventions for acute pain
The first thing you should do is identify the current pain intensity using the pain scale 0 to 10. Then determine the level on the pain scale that the patient can comfortably function at. As you begin the nursing interventions for acute pain, the main goal should be to achieve this comfortable pain scale level. It will be hard to complete any of your other interventions without consistently trying to meet that goal. If the patient is cognitively impaired them the goal should be that they show a read auction in pain behaviors, and perform their recovery activities satisfactorily.
Nursing Interventions for Acute Pain
Acute Pain in Geriatric patients
Pediatric patients and acute pain
Cultural Considerations with interventions for acute pain
Nursing interventions for acute pain
- Explore the need for both opioid and non-opioid pain medicine
- Determine the clients current medication is effective for the pain relief especially if the patient has taken the pain medicine all day with no relief.
- It is okay as a nurse, to suggest to the doctor a patient controlled analgesia (PCA) but most the time these are standard for acute pain that develops after surgery.
- If you can avoid it, try not to give pain medication intramuscularly due to pain from needle stick.
- Be clear to the patient about how the doctors and nurses are going to provide pain management, such as therapies, type medications to be given, to include side effects and complications.
- · Plan nursing care such as dressing changes, showers, ambulation when the patient is comfortable and has been given a pain medication about 30 min. before care is to be given. This will promote patient cooperation.
- · Sometimes patients have fears of taking medications they are not used to, find out if the patient has any fear of overdose or addiction to pain medication, whether ibuprofen or morphine. You would be surprised the amount of patients that are hesitant to even take aspirin at home.
- · When giving pain medication determine on a scale 0 to 10 what the patient's pain is before the pain medication is given, and 30 min. to an hour after pain medication to see if there has been a change.
- · When giving opioids check respiratory status and how often the patient is sedated about every two hours for the first 24 hours. Especially if the drug is new to them. It may be appropriate to awaken a patient that is sleeping if their respirations' are irregular, shallow, or they are snoring. If the patient exhibits excessive sedation notify the physician.
- · If more than one pain medication is ordered by the doctor, try to pepper the day with those medications to make it possible to treat breakthrough pain.
- · Determine if the client would like to use nonpharmacological methods to help control their pain such as distraction, imagery, relaxation, and heat application as well as cold.
- · Only attempt to teach non-medication interventions when the pain is well controlled with medication inventions.
- · It may be necessary to get a prescription from the doctor for a stool softener if not already ordered, narcotic medication can slow bowel function.
Nursing Interventions for Acute Pain
Culture and Nursing Interventions for Acute pain
Nursing interventions for acute pain in pediatric patients
- as a nurse teach the mother that is breast-feeding that it can reduce behavioral indicators of pain in those children.
- · obtain an order for a topical pain medication for child when placing an IV in an infant or child
- · obtain an order for appropriate dosage in babies that are experiencing moderate to severe pain
- · in young children(4 and older), use the Wong– Baker FACES scale or the faces pain scale to determine the level of pain present in a child.
Nursing interventions for acute pain in geriatric patients
- · take the report of pain in an older patient seriously and ensure the pain is relieved, do not let a diagnosis of dementia prevent you as a nurse from treating pain.
- · When assessing pain in a geriatric patient, make sure you're speaking clearly, slowly, and loudly enough for the client to hear. This can be done appropriately without being demeaning by simply asking the geriatric patient if they have trouble hearing.
- · Repeat information as needed make sure that the patient can see appropriately if you are using written material.
- · If the geriatric patient is a total assistance, do not force movement whether it be bed mobility or transfers, make sure that you handle the body gently and let them move at their own pace.
Nursing interventions for acute pain with cultural adjustments
- · determine if the patient is made cultural beliefs, or values about how they deal with pain
- · do not be afraid or ashamed to use safe and effective folk healthcare practices and beliefs as appropriate to the patient
- · some cultures prefer a family centered approach to care.
- · Encourage patients to use prayer to help cope with the pain as appropriate
- · use culturally relevant pain scales to help assess pain
- · make sure directions for medication use in the language of the person taking them
Nursing interventions for acute pain in a home care setting
- · incorporate the patient as well as their caregivers in the acute pain intervention plan
- · construct a medication reconciliation paper, that the patient and caregiver will be able to use as a guide to taking the pain medication.
- · Check the patients in the family's knowledge of the side effects and safety cautions of the pain medications that they are taking, such as not driving or using heavy machinery while taking.
- · Make sure the patient and the family know who to contact if the pain medication is not working properly.
Patient and family teachings involving acute pain
- · handout written material on a medication that patients are taking to include side effects and other drug interactions.
- · Avoid using the words drug or narcotics due to the stigma behind such words. Instead referring to them as pain medication.
- · Teach the patient and the family how to use the pain rating scale and to set goals for the patient's comfort.