It is well established that the client's report of pain is the best information the healthcare team can use in managing the client's pain. Below are questions to obtain information needed to develop an effective individualized plan of care for pain management (American Society for Pain Management Nursing, 2010).

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Chapter5: The Therapeutic Approach To The Patient With A Life-threatening Illness
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Chapter 25 Multiple Systems: Paln
674
Multiple Systems: Pain
System-Specific Assessments: Pain
"PQRST"
It is well established that the client's report of pain is the best information the healthcare team can use
in managing the client's pain. Below are questions to obtain information needed to develop an effective
individualized plan of care for pain management (American Society for Pain Management Nursing,
2010).
Assess:
• Pain history (i.e., prior experience with pain, what has relieved pain in the past, etc.)
• Vital signs
• Non-verbal cues (i.e., restlessness, verbal moaning, muscle tension, facial expression, etc.)
"PQRST"
Provokes: What causes pain? What alleviates the pain?
Quality: How does it feel? What is effect of pain on function & quality of life?
Radiates: Where is the pain and does the pain radiate to another location?
Severity/Intensity: How severe is the pain based on age appropriate pain scale?
(i.e., Visual Analog Scale, Numeric Rating Scale, FACES Pain Scale, etc.).
Time: When did the pain start? Is it constant or intermittent?
Multiple Systems: Pain
System-Specific Assessments: Pain
Types of Pain Scales
Pain scales are an objective way to help the client describe their pain to facilitate a plan of care for
effective pain management. The pain scale should be chosen that will best fit the individual needs and
developmental age of the client.
VISUAL ANALOG SCALE
(VAS)
NUMERIC RATING
SCALE (NRS)
FACES PAIN SCALE
REVISED FACES PAIN
RATING SCALE:
THE BEHAVIOR PAIN RATING SCALE
(BPS)
It is a line (10 cm) in length
with the words "No Pain"
at one end and at the other
end, the words "Worst
Pain Imaginable." The client intense, worst pain Frowning tearful face =
indicates where on the line
their pain is. The line can
have numeric value points
on it.
A scale of 0-10.
Word descriptions under 6
faces.
A reliable assessment tool for moderately
to deeply sedated clients because the
three measurements do not require client
cooperation or communication. Behaviors
0 = no pain
10 = the most
Smiling face = no pain
are:
worst pain
The faces are numbered 0,
2, 4, 6, 8 and 10.
The faces with 0 =no pain
to 10 =worst pain.
Restlessness
• Muscle tension
• Facial expression
• Vocalization
• Wound guarding
Behaviors are given a 0 to 2 rating with 2
being the worst.
No Pain
Worst Pain
Imaginable
Pain scale is reliable for use
with children and adults.
(Wagner & Hardin-Pierce, 2014)
Transcribed Image Text:Chapter 25 Multiple Systems: Paln 674 Multiple Systems: Pain System-Specific Assessments: Pain "PQRST" It is well established that the client's report of pain is the best information the healthcare team can use in managing the client's pain. Below are questions to obtain information needed to develop an effective individualized plan of care for pain management (American Society for Pain Management Nursing, 2010). Assess: • Pain history (i.e., prior experience with pain, what has relieved pain in the past, etc.) • Vital signs • Non-verbal cues (i.e., restlessness, verbal moaning, muscle tension, facial expression, etc.) "PQRST" Provokes: What causes pain? What alleviates the pain? Quality: How does it feel? What is effect of pain on function & quality of life? Radiates: Where is the pain and does the pain radiate to another location? Severity/Intensity: How severe is the pain based on age appropriate pain scale? (i.e., Visual Analog Scale, Numeric Rating Scale, FACES Pain Scale, etc.). Time: When did the pain start? Is it constant or intermittent? Multiple Systems: Pain System-Specific Assessments: Pain Types of Pain Scales Pain scales are an objective way to help the client describe their pain to facilitate a plan of care for effective pain management. The pain scale should be chosen that will best fit the individual needs and developmental age of the client. VISUAL ANALOG SCALE (VAS) NUMERIC RATING SCALE (NRS) FACES PAIN SCALE REVISED FACES PAIN RATING SCALE: THE BEHAVIOR PAIN RATING SCALE (BPS) It is a line (10 cm) in length with the words "No Pain" at one end and at the other end, the words "Worst Pain Imaginable." The client intense, worst pain Frowning tearful face = indicates where on the line their pain is. The line can have numeric value points on it. A scale of 0-10. Word descriptions under 6 faces. A reliable assessment tool for moderately to deeply sedated clients because the three measurements do not require client cooperation or communication. Behaviors 0 = no pain 10 = the most Smiling face = no pain are: worst pain The faces are numbered 0, 2, 4, 6, 8 and 10. The faces with 0 =no pain to 10 =worst pain. Restlessness • Muscle tension • Facial expression • Vocalization • Wound guarding Behaviors are given a 0 to 2 rating with 2 being the worst. No Pain Worst Pain Imaginable Pain scale is reliable for use with children and adults. (Wagner & Hardin-Pierce, 2014)
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