ASSESSMENT NURSING DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

ACUTE PAIN RELATED AFTER 4 HOURS OF 1. OBTAIN CLIENT’S 1. IN ORDER TO FULLY UNDERSTAND AFTER 4 HOURS
TO PROLONGED USE NURSING INTERVENTION ASSESSMENT OF PAIN TO CLIENT’S PAIN SYMPTOMS. NOTE: INTERVENTIONS THE
OF INDWELLING THE PATIENT WILL ABLE TO INCLUDE LOCATION, EXPERTS AGREE THAT ATTEMPTS PATIENT WAS ABLE TO
CATHETER AS REPORT PAIN IS RELIEVED CHARACTERISTICS, ONSET, SHOULD ALWAYS BE MADE TO OBTAIN REPORT PAIN IS RELIEVED
MANIFESTED BY OR CONTROLLED DURATION, FREQUENCY, SELF-REPORTS OF PAIN. WHEN THAT OR CONTROLLED.
PAINFUL WHEN QUALITY, INTENSITY. IS NOT POSSIBLE, CREDIBLE
URINATING 2. ACCEPT CLIENTS’S INFORMATION CAN BE RECEIVED
DESCRIPTION OF PAIN FROM ANOTHER PERSON WHO
3. MONITOR SKIN COLOR AND KNOWS THE CLIENT WELL.
TEMPERATURE AND VITAL 2. PAIN IS A SUBJECTIVE EXPERIENCE
4. WORK WITH CLIENT TO AND CANNOT BE FELT BY OTHERS.
PREVENT PAIN NOTE: SOME ELDERLY CLIENTS
5. ADMINISTER ANALGESIC AS EXPERIENCE A REDUCTION IN
INDICATED TO MAXIMUM RECEPTION OF PAIN OR HAVE
DOSAGE DIFFICULTY LOCALIZING OR
6. PROVIDE OR PROMOTE DESCRIBING PAIN, AND PAIN MAY BE
NONPHARMACOLOGICAL PAIN MANIFESTED AS A CHANGE IN
MANAGEMENT SUCH AS BEHAVIOR.
QUIET ENVIRONMENT AND 3. THIS WILL MAY ALTERED IN ACUTE
COMFORT MEASURES PAIN
4. TIMELY INTERVENTION IS MORE
LIKELY TO BE SUCCESSFUL IN
ALLEVIATING PAIN.
5. TO MAINTAIN ACCEPTABLE LEVEL OF
PAIN. NOTIFY PHYSICIAN IF REGIMEN
IS INADEQUATE TO MEET PAIN
CONTROL GOAL. COMBINATIONS OF
MEDICATIONS MAY BE USED ON
PRESCRIBED INTERVALS

1.