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Monday, November 28, 2011

Nursing Care Plan for Pain - Assessment, Diagnosis and Interventions

Pain

Pain is the most common reason a person seeking medical assistance. Pain occurs with the disease process, diagnostic examination and treatment process. Pain is very annoying and difficult for many people. The nurse could not see and feel the pain experienced by the client, because pain is subjective (between one individual with another individual is different in addressing the pain). Nurses provide nursing care to clients in various situations and circumstances, which provide interventions to improve comfort. According to some theories of nursing, comfort is the basic requirement that the client is the purpose of nursing care. The statement was supported by Kolcaba who said that comfort is a state has met basic human needs.

Definition of Pain

Pain is an unpleasant feeling that is conveyed to the brain by sensory neurons. The discomfort signals actual or potential injury to the body. However, pain is more than a sensation, or the physical awareness of pain; it also includes perception, the subjective interpretation of the discomfort. Perception gives information on the pain's location, intensity, and something about its nature. The various conscious and unconscious responses to both sensation and perception, including the emotional response, add further definition to the overall concept of pain.

What do you know about Pain ?
  • Pain is tiring and requires a lot of energy
  • Pain is subjective and individualized
  • Pain can not be objectively assessed as X-rays or blood lab
  • Nurses can assess patients' pain just by looking at physiological changes and behavior of client statements
  • Only the client knows when pain and pain arising
  • Pain is a physiological defense mechanism
  • Pain is a warning sign of tissue damage
  • Pain started the inability
  • The false perception that causes pain so pain management is not optimal

In summary, Mahon, argued pain following attributes:
  • Pain is an individual
  • Pain is not fun
  • Is a strength that dominate
  • Are endless



Nursing Assessment of Pain

Assessment of pain is factual and accurate information is required to:
  • Establish a baseline
  • Appropriate nursing diagnosis
  • Selecting a suitable therapy
  • Evaluate client response to therapy given
Nurses need to explore the experience of pain from the viewpoint of the client. The advantage for clients pain assessment is that the pain is identified, recognized as something tangible, measurable, can be explained, and used to evaluate treatment.

Things that need to be studied are as follows:
  1. Expression of the client to pain
    Many clients do not report / discuss the condition of discomfort. For that nurses must learn how verbal and nonverbal clients in communicating a sense of discomfort. Clients who are unable to communicate effectively often requires special attention when the assessment.
  2. Classification of pain experience
    Nurses assess whether the client felt the pain of acute or chronic. When acute, it takes a detailed assessment of the characteristics of pain and when pain is chronic, then the nurse to determine whether ongoing intermittent pain, persistent or limited.
  3. Characteristics of pain
    • Onset and duration. Nurses assess how long the pain is felt, how often pain relapse, and whether the appearance of pain at the same time.
    • Location. The nurse asks the client to indicate where the pain is felt, or feels settled on spread
    • Severity. The nurse asks the client describes how severe the pain is felt. To obtain these data the nurse can use assistive devices, measuring scales. Clients indicated the scale of measurement, then given the choice to suit current conditions. Measuring scale can be a numeric scale, descriptive, visual analogue.
  4. Effects of pain on the client
    Pain is stressful and can change the lifestyle and psychological well-being of individuals. Nurses should review the following things to determine the effect of pain on the client:
    • Signs and symptoms of physical
      Nurses assess the physiological signs, because of the pain that is felt the client could have an effect on the normal functioning of the body.
    • Behavioral effects
      Nurses assess verbal response, body movements, facial expressions, and social interaction. Verbal report of pain is a vital part of the assessment, nurses must be willing to listen and try to understand the client. Not all clients are capable of expressing the pain that is felt, for things like that nurses should be aware of client behaviors that indicate pain.
    • Effects on ADL
      Clients who experience pain are less able to participate in regular daily activities. This assessment indicates the extent of the adjustment process the client capabilities and participate in self-care. It is important also to assess the effects of pain on the client's social activities.
  5. Neurological status
    Neurological function more easily influence the pain experience. Any factors that interfere with or affect the reception and perception of pain that would normally affect the client's responses and awareness of pain. It is important for nurses to assess the neurological status of the clients, because clients who have neurological disorders are not sensitive to pain. Preventive action needs to be done on the client with a neurological disorder that easily injured.

Nursing Care Plan for Pain - Assessment, Diagnosis and Interventions

Nursing Diagnosis for Pain
  1. Acute Pain related to physical injury, reduction of blood supply, process of giving birth
  2. Chronic Pain related to the malignancy
  3. Anxiety related to pain that is felt
  4. Ineffective individual coping related to chronic pain
  5. Impaired physical mobility related to musculoskeletal pain
  6. Risk for injury related to lack of perception of pain
Nursing Interventions for Pain

Nurses develop a plan of nursing diagnoses that have been made. Nurses and clients together to discuss realistic expectations of action to overcome the pain, the degree of recovery of the expected pain, and the effects that must be anticipated in the client's lifestyle and function. Expected outcomes and goals of nursing and nursing diagnoses were selected based on the client's condition. The general objective of nursing care with pain are as follows:
  • Clients feel healthy and comfortable
  • Clients retain the ability to perform self-care
  • Clients maintain physical function and psychological currently owned
  • Client describes the factors that cause pain
  • Clients use the therapy given safely at home

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