Pain assessment is the process by which a patient is taken through a series of questions and examinations in order to determine the cause of pain, the level at which the pain is affecting the problem and treatment for the pain. Therefore, it is compulsory for all nurses to have the necessary knowledge and expertise to assess pain in a patient so as to provide efficient patient care. The nurses using the report from the pain assessment are able to give the doctors an easier time to diagnose the problem and thereafter recommend the required type of treatment.
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In the case study of an elderly man who actively participates in golf, pain assessment on his substernal chest pain is conducted only by a qualified nurse. Pain assessment involves asking of questions whereby the nurse and the patient enter into a form of dialogue. The PN and the LPN (licensed practical nurse) take the patient over the pain assessment process. The expertise of the nurse requires her to administer the questionnaire in order of urgency by asking questions in a certain order. The series of questions should complement each other, and the first should be the most important for both the patient and for the doctors as they perform the particular diagnosis.
In case of chest pain, the nurse should come up with questions of the following kind so as to determine the pain level and how to manage it. Using the PQRSTU method of questioning in nursing the nurse must ask the patient the following questions. The first question to the patient must be on provocation or palliation. What triggered the pain according to the patient? This may be because of a certain move the patient made during golfing or something else. The question that follows is on quality and quantity in matters on which kind of movements make the pain worse or relaxed. Moreover, the pain might be sharp or stabbing. The patient must describe what the pain feels like.
The third question is on radiation and region in which the pain is being felt. The patient should tell or point where exactly the pain is felt. This gives the nurse a highlight of the part of the chest with problems. The fourth question must be on the severity of the pain. The patient must briefly describe the amount of pain to the nurse. This is important for documentation in the report. The LPN must take part in the pain assessment by documenting the patient’s responses to the nurse. The fifth question is on timing. The patient should tell how long or rather the period of time the patient has experienced the pain. These may be minutes or hours. This helps the nurse determine which other parts of the body connect to the cause of pain. The sixth and last question is on urgency. The patient should say if the pain is bearable or not so that the nurse could establish the urgency of the patient’s pain management.
The reason why the nurse carries out the above questionnaire with the patient is to help the doctors come up with the correct diagnosis for the patient’s situation. The key reason for a diagnosis is to help manage the pain of the patient by reducing the pain and assuring the patient of comfort especially in such severe cases of a chest discomfort that happens to be strange even to the patient. The questions also give the patient an opportunity to get involved in his own treatment thus making him feel responsible for his health and general well-being, (Pasero, 2011).
“As a registered nurse I realize that the patient is going through a serious chest problem as the pain is sudden and unusual for the patient. The situation is urgent and quick response by the doctors is required so as to hasten the treatment. The patient might be suffering from several stresses at the golf club or the pain might be as a result of anxiety of an upcoming match. This old man is quite active, and the chest problem if severe will lead to him quitting the sport. From my understanding, the answers from this old man are quite clear that he is preparing for an important match and the anxiety might have caused the sudden unusual pain”
“The patient must first undergo a stress test because of the anxiety he seems to have. This will enable him to relax if he is diagnosed to be going through stress. The family of the old man especially if he has a wife should come through and help his husband cope with the stress. In addition, conduction of a chest x ray will take place to determine and assess the specific area of pain and the possibilities of other serious chest problems that have caused the pain, for instance, a pulmonary embolism. I recommend anti anxiety drugs and pain relievers for the patient as he awaits the x ray results”
In conclusion, it is observed that pain assessment is effective where professional nurses are involved. The LPN should be delegated to perform various tasks under the supervision of the PN. The licensed practical nurse must care for the patient assisting in managing the pain. The licensed practical nurse must follow the instructions of the PN in order of priorities during the patient’s care in the hospital. In addition, the LPN must monitor the condition of the patient even after the pain is stabilized. Information on how to assess pain should also be made available for the public in case they need to administer pain where there is an emergency.
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