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NCLEX & CGFNS Practice Questions
  • Acute
  • Chronic

Related To: [Check those that apply]

  • Postoperative pain
  • Cardiovascular pain
  • Musculoskeletal pain
  • Obstetrical pain
  • Pain resulting from medical problems
  • Pain resulting from diagnostic procedures or medical treatments
  • Pain resulting from trauma
  • Pain resulting from emotional, psychological, spiritual, or cultural distress

As evidenced by: [Check those that apply]

  • Patient reports pain
  • Guarding behavior, protecting body part
  • Self-focused
  • Narrowed focus (altered time perception, withdrawal from social or physical contact)
  • Relief or distraction behavior (e.g., moaning, crying, pacing, seeking out other people or activities, restlessness)
  • Facial mask of pain
  • Alteration in muscle tone: listlessness or flaccidness; rigidity or tension
  • Autonomic responses not seen in chronic, stable pain (e.g., diaphoresis; change in blood pressure (BP), pulse rate; pupillary dilations; change in respiratory rate; pallor; nausea)

Patient’s Diagnosis: –
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Objective/Expected Outcome;The patient will:

  • verbalizes adequate relief of pain or ability to cope with incompletely relieved pain.
  • Others

Note: you need to indicate time frame/target as objective must be measurable.

Nursing Interventions Scientific Rationale
Assess pain characteristics (e.g., quality, severity, location, onset, duration, and precipitating factors). This will help to guide clinical decision.
Observe or monitor signs and symptoms associated with pain, such as BP, heart rate, temperature, color and moisture of skin, restlessness, and ability to focus. Some people deny the experience of pain when present. Attention to associated signs may help the nurse in evaluating pain.
Assess for probable cause of pain. Different etiologic factors respond better to different therapies.
Evaluate patient's response to pain and medications or therapeutics aimed at abolishing or relieving pain. It is important to help patients express as factually as possible (i.e., without the effect of mood, emotion, or anxiety) the effect of pain relief measures.
Assess to what degree cultural, environmental, intrapersonal, and intrapsychic factors may contribute to pain or pain relief. These variables may modify the patient's expression of his or her experience.
Evaluate what the pain means to the individual. The meaning of the pain will directly influence the patient's response. Some patients, especially the dying, may feel that the act of suffering" meets a spiritual need."
Assess patient's expectations for pain relief. Some patients may be content to have pain decreased; others will expect complete elimination of pain. This affects their perceptions of the effectiveness of the treatment modality and their willingness to participate in additional treatments.
Assess patient's willingness or ability to explore a range of techniques aimed at controlling pain. Some patients will feel uncomfortable exploring alternative methods of pain relief.
Anticipate need for pain relief. One can most effectively deal with pain by preventing it. Early intervention may decrease the total amount of analgesic required.
Respond immediately to complaint of pain. In the midst of painful experiences patient's perception of time may become distorted. Prompt responses to complaints may result in decreased anxiety in patient.
Eliminate additional stressors or sources of discomfort whenever possible. Patients may experience an exaggeration in pain or a decreased ability to tolerate painful stimuli if environmental, intrapersonal, or intrapsychic factors are further stressing them.
Provide rest periods to facilitate comfort, sleep, and relaxation. The patient's experiences of pain may become exaggerated as the result of fatigue.
Give analgesics as ordered, evaluating effectiveness and observing for any signs and symptoms of untoward effects. Pain medications are absorbed and metabolized differently by patients, so their effectiveness must be evaluated from patient to patient.
Notify physician if interventions are unsuccessful or if current complaint is a significant change from patient's past experience of pain. Patients who request pain medications at more frequent intervals than prescribed may actually require higher doses or more potent analgesics.
Whenever possible, reassure patient that pain is time-limited and that there is more than one approach to easing pain. When pain is perceived as everlasting and unresolvable, patient may give up trying to cope with or experience a sense of hopelessness and loss of control.
Instruct patient to report pain. So that relief measures may be instituted.
Teach patient preoperatively. So that anesthesia effects do not obscure teaching.

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