Check the MARs and nurses’ notes for the past several days.
Ask the nurse educator to give an in-service about pain management.
Perform a complete pain assessment and history on the client.
Have a conference with the nurses responsible for the care of this client.
A client with fibromyalgia
A client with phantom limb pain
A client with progressive pancreatic cancer
A client with trigeminal neuralgia
Make a note in the nurse’s file and continue to observe clinical performance
Refer the new nurse to the in-service education department.
Quiz the nurse about knowledge of pain management
Give praise for the correct dose and time and discuss the deficits in charting.
Simple description pain intensity scale
0-10 numeric pain scale
Faces pain-rating scale
McGill-Melzack pain questionnaire
Treatment is based on client goals.
A multidisciplinary approach is needed.
The client must be believed about perceptions of own pain.
Drug side effects must be prevented and managed.
Patient-controlled analgesia (PCA)
Administer smallest dose that provides relief with the fewest side effects.
Titrate upward until the client is pain free.
Titrate downwards to prevent toxicity.
Ensure that the drug is adequate to meet the client’s subjective needs.
Use of heat and cold applications
Transcutaneous electrical nerve stimulation (TENS)