It’s up to nurses working in both inpatient and outpatient healthcare facilities to manage pain as it is experienced by their patients. But not all pain is created equally – pain levels can vary wildly, depending on their origin, and the pain tolerance of the patient in question. Addressing and caring for pain requires strategy, creativity, and careful planning on the part of the attendant nurse if they are going to treat their patient efficiently and effectively.
What is a Nursing Care Plan for Pain?
Pain often has mysterious origins, and treating it can feel a bit like detective work if the cause of this symptom isn’t immediately obvious.
Care plans designed to address and treat pain in presenting patients help nurses to annotate, track, and divise course of action to address a patient’s pain. A nurse might note the characteristics of the pain, a diagnosis of the pain itself or source of pain, and then set a plan for course of action. The strategy may change depending on the presenting symptoms or medical history of the patient: for example, a nursing care plan for pain after surgery will require a different approach than a patient in pain without an easily explained source.
As a document, the care plan will typically include the date and time, expected outcomes for treatment, interventions utilized to address pain, and whether the intended outcomes were met or unmet.
How is Pain Defined?
Most broadly, pain falls into two categories: acute, and chronic.
Acute pain is defined as an unpleasant sensory and emotional experience which is the result of actual or potential tissue damage. This type of pain may be sudden OR gradual in its onset, and lasts less than 6 months in duration.
Chronic pain is defined as an unpleasant sensory and emotional experience which is persistent, and lasts over 6 months, and potentially the patient’s entire life.
Patients with chronic pain, owing to any number of conditions or disabilities, may experience acute pain which is either a symptom of their chronic illness, or an additional separate source. Similarly, acute pain may be experienced periodically over a great length of time, thus blurring the lines between the two categories.
Upon admittance to either a hospital or clinic, patients are typically asked to rate their pain on a scale of 1 to 10, with 1 being no pain, and 10 being the worst pain the patient has ever felt. But pain is a little more complicated than this, as you are already aware. Additional categories of pain include nociceptive, somatic or visceral pain; and neuropathic, or nerve pain. “Other” pain defines the unpleasant sensation which arises from unknown causes and cannot be located within the body: this may be due to psychological traumas, however it should be taken as seriously as pain due to bodily injury.
The type of pain, along with the level of pain being experienced, will initially determine the course of care the attending nurse will choose to take.
Example Nursing Care Plan for Pain
In this section you will find a detailed example of a nursing care plan for pain.
Scenario:
A 34 year old female is admitted with vision loss in one eye, and general loss of fine motor control. She states experiencing severe pain, localized to her cranial cavity. After receiving a saline drip, the patient’s motor controls normalize, but the headache and vision loss remains. She describes the pain as throbbing. The patient receives MRI scans which demonstrate no irregularities or tumors in her brain, and she is diagnosed with a Retinal Migraine.
Nursing Diagnosis
Acute pain related to cephalgia, secondary to retinal migraine. Patient rates pain 8 – 10 and is extremely sensitive to light, sounds. Minimally verbally communicative.
Subjective Data
Patient states she is still unable to see out of her left eye, additionally that throbbing headache persists. She states that she experiences it primarily behind her eyes and forehead. She states that her mother has experienced retinal migraines, and that the patient herself has had migraines without vision symptoms in the past. She rates her pain 8 – 10.
Objective Data
34 year old female admitted with monocular vision loss, impaired fine motor control, and cephalgia. Motor control returned after administration of saline drip; cephalgia and vision loss persistent.
Nursing Outcomes
- The patient will verbalize decrease in pain levels maximum 6 within 24 hours after receiving pain medication.
- The patient will verbalize improvement of vision in left eye within 24 hours after receiving vasodilators.
- The patient will verbalize decrease in pain levels maximum 2 within 48 hours after receiving pain medication.
- The patient will verbalize complete return of vision in left eye within 48 hours after receiving vasodilators.
- The patient will verbalize 5 indicators of a pending migraine.
- The patient will verbalize how to correctly take Motrin before discharge.
Nursing Interventions
- The nurse will assess the patient’s pain level every 2 hours while patient is awake until pain level drops to below 3.
- The nurse will assess the patient’s vision every 5 hours while patient is awake until vision is completely restored.
- The nurse will educate the patient on signs of a pending migraine.
- The nurse will educate the patient on the proper administration of Motrin.
Final Thoughts: Example Nursing Care Plan for Pain
Pain happens for many reasons, and the appropriate course of action will differ depending on the type of pain experienced, and the underlying cause. Each patient will experience pain differently, and it is imperative to take a patient’s pain seriously in order to provide high-quality care.