Outcome Identification and Planning
Sample desired outcomes include the following:
- The client relates relief after a satisfactory relief measure evidenced by client stating that pain has decreased from level 8 to level 2 or lower.
- The client verbalizes that anxiety level is lower compared to pain.
- The client demonstrates nonverbal cues of comfort, such as relaxed facial expression.
Special Considerations in Planning and Implementation
Remember that the client is the expert regarding pain. The nurse's direct observations should not be used to dispute the client's perception. Pain is present if the client says it is. Perform pain assessment with vital signs and additional times as indicated.
Use nonverbal cues to determine the presence of pain in newborns, infants, and toddlers. Although children as young as 8 years can use a 0-to-10 scale, a graphic rating scale, such as a faces chart, can be quite effective.
Remember that elderly clients often have multiple sources of pain. Pain may be chronic, and the elderly client may demonstrate a stoic approach to pain. Observe for nonverbal cues of pain if cognitive impairment is present. Assess for altered pain sensation in some elderly clients, particularly if diabetes or neurovascular disease is present.
Transcultural Consider the impact of the individual's culture when assessing pain level. Open expression of pain is encouraged in some cultures, while other cultures value stoic responses to pain as something to be ignored or endured in silence.
Pain assessment should be performed by a nurse, particularly with ongoing pain management (e.g., PCA or epidural) and when interpretation of nonverbal cues is needed. In some facilities, unlicensed staff may be trained in basic pain assessment.