Nursing Care Plan (NCP) for Acute Pain
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Outline
Lesson Objective for Nursing Care Plan for Acute Pain
Think of acute pain as your body’s alarm system. It’s a way for your body to say, “Hey, something’s not right here!” This type of pain comes on quickly and is usually sharp or intense. It’s like when you accidentally cut your finger or stub your toe. The pain is sudden and tells you right away that you’ve been hurt.
Acute pain is different from chronic pain, which lasts a long time and can be more about an ongoing condition. Acute pain is usually short-term. It starts suddenly because of something specific, like an injury, surgery, or a dental procedure, and it goes away once the injury heals.
In simple terms, acute pain is like a warning signal that something needs attention right now. It’s usually clear what caused it, and it tends to go away as the cause gets treated or the body heals.
In the nursing care plan for acute pain:
- Identify and assess diverse causes of acute pain.
- Implement tailored interventions for effective pain relief.
- Promote overall comfort and functioning in individuals experiencing acute pain.
- Emphasize the importance of addressing underlying causes to prevent pain recurrence.
- Demonstrate a comprehensive and patient-centered approach to acute pain management.
Pathophysiology
- Physiological Basis of Acute Pain:
- Acute pain, a common experience, happens when our body goes through complex changes due to injury or damage to tissues. Special nerve endings, called nociceptors, detect these changes and send signals to our spinal cord and brain, interpreting them as pain. This serves as a vital alarm system, prompting protective responses.
- Amplification by Inflammation:
- When tissues get hurt, the body releases inflammatory chemicals, making the pain signals stronger. It’s like the body’s way of saying, “Be careful, something’s not right.”
- Brain’s Role in Pain Perception:
- Our brain processes these signals, creating the feeling of acute pain. Understanding how this works is crucial for healthcare providers to develop targeted treatments that ease pain, help in healing, and improve the overall well-being of those going through acute pain episodes.
- Nature and Duration of Acute Pain:
- Acute pain is a sudden type of pain that usually lasts less than 3-6 months. It acts like a warning sign, indicating a possible disease or threat to the body. The pain usually goes away when the underlying cause is treated or healed.
Etiology
- Diverse Causes of Acute Pain:
- Acute pain can arise from various sources that trigger the body’s pain response. Common culprits include injuries, trauma, or damage to tissues, activating specialized nerve endings known as nociceptors. Additionally, surgical procedures, medical conditions, or illnesses can contribute to the experience of acute pain.
- Inflammation’s Role in Intensifying Pain:
- In response to tissue injury, inflammation occurs, releasing chemicals that make the specialized nerve endings, and nociceptors, more sensitive. This heightened sensitivity intensifies the perception of pain. Underlying health issues, like infections or diseases, can further contribute to the development of acute pain.
- Crucial Understanding for Tailored Interventions:
- Recognizing the diverse causes of acute pain is crucial for healthcare providers. It enables them to customize interventions that specifically address the underlying factors, effectively managing and alleviating the pain experienced by individuals. This tailored approach contributes to more precise and comprehensive pain care.
Desired Outcome
- Managing Acute Pain: Desired Outcomes:
- The main goal in handling acute pain is to achieve effective pain relief, improve overall comfort, and encourage a return to regular functioning. This involves reducing pain intensity to a level that lets individuals engage in their daily activities, promoting movement and participation in their usual routines. Effective pain relief also contributes to better sleep and overall well-being.
- Comprehensive Approach:
- The desired outcome goes beyond just easing the pain; it includes addressing any underlying causes or factors that may contribute to acute pain. This comprehensive approach aims to prevent the recurrence of pain episodes.
- Tailored Interventions for Quality of Life:
- To achieve these outcomes, healthcare providers tailor interventions to meet the specific needs of each individual and address the root causes of pain. This personalized approach aims to optimize the overall quality of life for those experiencing acute pain, supporting not only physical well-being but also emotional and functional aspects.
Subjective Data
- Sharp pain
- Throbbing
- Burning
- Stabbing pain
- Weakness
- Tingling
Objective Data
- Guarding a body part
- Facial expression (crying, moaning,)
- Profuse sweating
- Alteration in BP, HR, RR
Nursing Assessment for Acute Pain
- Pain Description:
- Obtain a detailed description of the pain, including its location, intensity (using a pain scale), quality (sharp, dull, throbbing), and any factors that exacerbate or alleviate the pain.
- Onset and Duration:
- Investigate when the pain began, how it started, and the duration of the pain. Determine if the pain is constant or intermittent and if there are any patterns to its occurrence.
- Impact on Daily Activities:
- Assess how the pain is affecting the individual’s ability to perform daily activities, including self-care, work, sleep, and social interactions. Inquire about any limitations or disruptions caused by the pain.
- Pain Alleviating and Aggravating Factors:
- Identify factors that alleviate or exacerbate the pain. This may include specific movements, positions, medications, or interventions that provide relief, as well as activities or triggers that worsen the pain.
- Pain History:
- Gather information about the patient’s pain history, including any previous episodes, treatments tried, and their effectiveness. Explore the patient’s pain tolerance and coping mechanisms.
- Physical Assessment:
- Perform a physical examination to assess for any visible signs of pain, such as guarding, facial expressions, and changes in vital signs. Pay attention to non-verbal cues that may indicate pain.
- Emotional and Psychosocial Assessment:
- Evaluate the emotional and psychosocial impact of pain. Inquire about feelings of anxiety, depression, frustration, or fear related to the pain. Assess the patient’s support system and coping mechanisms.
- Cultural Considerations:
- Recognize cultural influences on pain perception and expression. Inquire about any cultural or spiritual beliefs that may affect the patient’s experience of pain and their preferences for pain management.
- Communication Style:
- Consider the patient’s communication style and preferences for expressing pain. Some patients may be more comfortable using a numeric pain scale, while others may prefer descriptive terms.
- Pain Management History:
- Obtain information about the patient’s history of pain management, including medications, therapies, and alternative approaches. Determine the patient’s response to previous pain interventions.
- Patient’s Goals and Expectations:
- Discuss the patient’s goals and expectations regarding pain management. Identify realistic outcomes and collaborate with the patient to establish a plan that aligns with their preferences and values.
Nursing Interventions
| Nursing Intervention (ADPIE) | Rationale |
| Subjective pain assessment -asking where it hurts, how long, and what makes it better. Or worse? What have they tried to relieve pain?” Use a pain scale to assess pain level | better understanding their pain will better help you in where you should begin in treating their level of pain |
| Assess VS | elevated BP, HR, and RR if the patient has a lot of pain. |
| Diagnostics/Physical Assessment | CT scan- broken bones/internal bleeding
Physical assessment to toe to indicate a cause for the acute pain |
| Pharmacological Methods | OTC medications (NSAIDS/Tylenol)
Narcotics- patient may need something much stronger to control their pain |
| Non-pharmacological Methods | heat/ice, massage, relaxation techniques, distraction |
Evaluation of Acute Pain
- Pain Relief:
- Assess the degree of pain relief achieved compared to baseline, utilizing the patient’s self-report and observational cues. Evaluate the effectiveness of pharmacological and non-pharmacological interventions in reducing pain intensity.
- Functional Improvement:
- Evaluate improvements in the patient’s ability to perform daily activities and tasks. Assess any changes in mobility, self-care, and participation in social interactions, indicating enhanced functionality.
- Patient Satisfaction:
- Obtain feedback from the patient regarding their satisfaction with the pain management plan. Assess if the patient’s expectations were met, if they felt adequately involved in decision-making, and if their concerns were addressed.
- Adverse Effects:
- Monitor for any adverse effects related to pain management interventions, particularly those associated with medications. Address and manage any side effects promptly to ensure the patient’s safety and comfort.
- Psychosocial Well-being:
- Evaluate the impact of pain management on the patient’s psychosocial well-being. Assess changes in mood, anxiety levels, and overall emotional state. Determine if the patient’s coping mechanisms have been effective.
- Patient Education:
- Assess the patient’s understanding of pain management strategies and the ability to implement them independently. Provide additional education or clarification as needed to empower the patient in managing future episodes of acute pain.
- Long-Term Planning:
- Collaborate with the patient to develop a long-term pain management plan, considering potential future episodes of acute pain. Discuss preventive measures, lifestyle modifications, and strategies for early intervention.
- Communication and Collaboration:
- Evaluate the effectiveness of communication and collaboration among the healthcare team in managing acute pain. Ensure that there is a coordinated approach to pain management that addresses the patient’s holistic needs.
- Patient Empowerment:
- Assess the patient’s sense of empowerment and control over their pain. Evaluate their ability to communicate pain needs, make informed decisions about their care, and actively participate in the management of their pain.
References
https://my.clevelandclinic.org/health/articles/12051-acute-vs-chronic-pain
https://health.ucdavis.edu/livinghealthy/topic/pain-management/acute-pain-verses-chronic-pain.html
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Transcript
Hey everyone. Today, we are going to be putting together a nursing care plan for acute pain. So let’s get started. First, we’re going to go over the pathophysiology. So acute pain is a sudden type of pain that typically lasts less than three to six months. It serves as a warning sign of a disease or a threat to the body. It disappears when the underlying cause of pain has been treated or has been healed. Some nursing considerations. You want to make sure you’re doing a full head to toe assessment, doing some subjective pain assessments, some vital signs, diagnostic testing, and some pharmacological or non-pharmacological pain methods. Desired outcome: patient reports a satisfactory pain level using the numeric pain scale, maintains baseline vitals, and uses non-pharmacological or pharmaceutical pain relief strategies effectively.
So we’re going to go ahead and go through with our care plan. We’re going to go over some subjective data and we’re going to go through some objective data. So what are we going to see? Or what is the patient going to tell us? So some subjective data is going to be some sharp pain. They may describe it as being a throbbing pain or a stabbing pain. What we can see, they might be guarding the area that’s in pain. So you’ll see them guarding an area, maybe some facial expressions. So some grimacing or crying. It could also be described as burning or having weakness or some tingling. There could be some profuse sweating, some alteration in the blood pressure, heart rate, and respiratory rate – can see all of these with some pain with these patients.
So interventions: you want to get a subjective pain assessment. So with the subjective pain assessment, you are going to see for how long they’ve had this pain and where the pain hurts? Have they tried anything that’s worked or what makes it worse? Have they tried anything at home that has worked? So you want to use a pain scale as well to just assess where they are with their pain. So we, we have a better understanding of their pain. We’ll be able to better help them and know kind of where we want to start in the treatment plan. Another invention we want to do. We want to make sure we’re monitoring their vital signs; they can have an elevated blood pressure, an elevated heart rate, and elevated respiratory status when they’re having pain. All of these can be elevated. So we want to monitor all of that.
Another intervention we want to do, we can do some diagnostic testing, physical assessment, and a CT scan. So maybe they felt like they might have broken something. So maybe we’re looking for some broken bones or some internal bleeding. When we’re doing our head and toe assessment, we want to make sure that we’re indicating any sort of cause for the acute pain. Another invention we’re going to be doing is possible pharmacological methods for pain. So we’re going to give medications; we can use OTC meds. So this could be like your NSAIDs or Tylenol for the pain. But with acute pain, sometimes OTC medications don’t always work for the patient. Maybe they need some narcotics, some stronger pain medication for that pain, right?
And sometimes we try to use some non-pharmacological methods; this can be just some heat or ice applied to a certain area, maybe massaging the area. Maybe it’s some relaxation techniques or distraction. Most of the time, you’re going to find that with patients that have acute pain, these non-pharmacological methods don’t work and you end up having to use these pharmacological methods. But for some patients, they like to try more of the non-pharmacological first and then move on to giving actual medications.
Alright, we’re going to move on to some of the key points. So pathophysiology and etiology: acute pain is a sudden type of pain that typically lasts less than three to six months and serves as a warning sign of a disease or some sort of threat to the body system. Some call can be surgical pain, some traumatic pain, like a broken bone and some muscle strain.
Some subjective or objective data. The patient can complain of sharp pain. Maybe it’s throbbing, burning, or stabbing. They’re having some weakness, tenderness. You might see them guard the body part that hurts. Maybe some profuse sweating, and some alteration in their blood pressure, heart rate, respiratory rate – they’re all going to be elevated. We’re going to do a thorough assessment, maybe do some diagnostic testing. So you’re going to make sure you’re doing a full head to toe assessment. You’re looking for any sort of injury. Some subjective pain assessment. So you’re going to be asking them when the pain started and if they’ve tried any sort of pain relief methods at home; trying to figure out where the pain might be. Some vital signs, a CT scan, if needed, and some pain relief. So some pharmacological methods of pain relief, such as NSAIDs and narcotics or some non-pharmacological methods. So heat, heat, ice packs, massage, and distraction techniques can help. Alright, there you go. There’s that care plan for you.
You guys did awesome. We love you guys. Go out, be your best self today and as always happy nursing.
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