PAIN ASSESSMENT
AND
MANAGEMENT
MR. SWAPNIL WANJARI
CLINICAL INSTRUCTOR.
WHAT IS PAIN ?
Pain is an unpleasant sensation and emotional
experience that links to tissue damage.
- International association for the study of pain
(IASP)
TYPES OF PAIN
Acute pain – Short duration, healing process in 30 days.
Chronic pain – Its persist for the more than 3-6 month.
Physiological pain- it leads to potential tissue damage.
Somatic pain – It involves superficial tissues (skin, bone,
muscle, joints)
Visceral pain- It involves organs (heart, stomach & liver)
Neuropathic pain – changes in the nerve cells.
ASSESSMENT OF PAIN
Assessment of pain includes,
Subjective data
Objective data
SUBJECTIVE DATA
1. PAIN HISTORY:
While taking pain history, nurse must provide an
opportunity for clients to express their own words, how
they view it and their situation.
This is will help the nurse to identify patient pain and
how to cope up with it.
SUBJECTIVE DATA
2. ONSET AND DURATION OF OCCURRENCE:
When did pain begin?
How long has it lasted?
Does it occur at same time each day?
How often does it occur?
SUBJECTIVE DATA
3. LOCATION:
In which area it is felt? Do the areas differ under
different circumstances?
If several parts of body are painful, do pains occur simultaneously?
Is pain unilateral/ bilateral?
Ask the individual to point site of discomfort?
SUBJECTIVE DATA
4. INTENSITY:
Use of pain intensity scale is an easy and reliable method of
determining the client‟s pain intensity.
Most scales are either 0 to 5 or 0 to 10
Currently used scales are:
Numerical scale
Descriptive scale
Visual analog scale
TYPES OF PAIN SCALE
1. NUMERICAL SCALE
2. DESCRIPTIVE SCALE
3. VISUAL ANALOG SCALE
PAIN ASSESSMENT SCALE
1. Numerical rating scale:
A numerical rating scale with the range of 0 to 10 is
another type of pain scale that is used.
The word „no pain‟ appear by “0” and “worst pain
possible” is found by “10”.
Patient are asked to choose a number from 0 to 10 that
best reflects his/her level of pain.
NUMERICAL RATING SCALE
PAIN SCALE
2. Descriptive &Verbal rating scale:
Verbal pain scales as name suggest, use words
to describe pain. Word such as no pain, mild pain,
moderate pain and severe pain are used to describe
pain levels.
PAIN SCALE
3
PAIN SCALE
NURSING ASSESSMENT
Assess the patients risk for pain (Ex. Those
undergoing invasive procedures, anxious
patients)
Assess the patient response to previous
pharmacological interventions, especially ability to
function.
Examine the site of patient‟s pain or discomfort.
Assess for physical, behavioral and emotion signs and
symptoms of pain:
(Decreased activity, abnormal guilt and
irritability)
OBJECTIVE DATA
OBJECTIVE DATA
OBJECTIVE DATA
OBJECTIVE DATA
PREPARATION OF EQUIPMENTS
1. Pain scale
2. Privacy screen as per need
3. Patient case sheet
NURSING PROCEDURE
S. NO NURSING PROCEDURE ACTION
NURSING PROCED RE
1. Explain the procedure to the patient. Promotes compliance.
2. Wash hand and wear gloves if To prevent
needed. transmission of
microorganisms.
3. Provide privacy if needed. To provide comfort.
4. Ensure presence of easy lighting. For easy assessment.
5. Assess the level of pain using a
pain scale in the following method:
• assess characteristics of pain, using
PQRST of pain assessment:
Provocative/palliative factors-
What makes your pain better or
worse?
Quality – tell me what your
pain feels like?
Region / radiation – show me
Where your pain is. Where is the
Pain spreading to?
Severity – using a pain intensity
scale appropriate to the patient age,
developmental level, and
comprehension, ask the patient to rate
the pain, it has to be related in
descriptive and numerical scale for
adults and visual analog for children.
Timing – ask the patient if pain is
continuous, intermittent, and
constant or a combination.
Ask the patient, “How is the pain
affecting you?”
6. Ask the remedial non- pharmacological To decide the care to
and pharmacological taken at home and be given and the avoid
in the hospital. duplication of care.
7. Mark it in the pain assessment form. Serves as an
evidence for the
care.
8. Perform hand hygiene and Reduces
Discard gloves, if used. transmission of
infections.
RECORDING & REPORTING
Record and report the character of pain before
intervention, therapies used and patient‟s response.
SAMPLE DOCUMENTATION
Patient expressed constant pain at the lumbar region
of the back. He/she said that it does not radiate but
increases with mild physical activity. The level of
pain was assessed using numerical and descriptive
pain scale. The pain score was 6/10 and the patient
expressed moderate level of pain. Hot water bag
applied and T. Dolo 650mg administered as per
doctors order.
THANK YOU ……
