PAIN ASSESSMENT
AND
MANAGEMENT
MS.R.DEVISRI, B.Sc (N).,
NURSING TUTOR,
KARPAGA VINAYAGA COLLEGE OF NURSING.
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 occurs?
SUBJECTIVE DATA
3. LOCATION:

In which area it is felt? Do the area differ under different
circumstances?

If several parts of body are painful, do pain 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 clients 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.
DESCRIPTIVE SCALE
2.
NUMERICAL 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. 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. Visual analogue scales:

VAS use a vertical or horizontal line with words that
convey “no pain” at one end and “worst pain” at
opposite end.

Patient is asked to place a mark along line that
indicates his/her level of pain.
VISUAL ANALOG SCALE
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 patients pain or discomfort.
 Assess for physical, behavioral and emotion signs
and symptoms of pain:
(moaning, 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
1.
Explain the procedure to the
Promotes compliance.
NURSING PROCEDURE
patient.
2.
Wash hand and wear gloves if
needed.
To prevent
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 PQRSTU of pain assessment:
Provocative/palliative factorswhat 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,
constant or a combination.
Ask the patient , “ how is the
pain affecting you?”
6.
Ask the remedial nonpharmacological and
pharmacological taken at home
and in the hospital.
To decide the care to
be given and the
avoid duplication of
care.
7.
Mark it in the pain assessment
form.
Serves as an
evidence for the
care.
8.
Perform hand hygiene and
discard gloves, if used.
Reduces
transmission of
infections.
RECORDING & REPORTING

Record and report the character of pain before
intervention, therapies used and patients
response.
SAMPLE DOCUMENTATION

Patient expressed constant pain at the lumbar
region of the back. He/she said that it does not
radiate but increases eve 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 ……