ACUTE PAIN ADPIE
Assessment:
Changes in appetite
Diaphoreses (sweating)
Vital signs changes, Elevated HR, BP, RR
Distraction behavior
Evidence of pain using standardized pain behavior checklist for those unable to communicate verbally
Expressive behavior, facial expressions
Guarding behavior
Positioning to ease pain
Pupil dilation
Self-report of pain using pain scale; characteristics using standardized pain instrument
Diagnosis: Acute pain related to…
Biological
Chemical
Physical
Plan:
The patient will identify pain intensity on a pain scale and rate the pain consistently
…identify factors that increase pain
…state and carry out ways to decrease the pain
…notify health care provider of pain before pain becomes unmanageable or unbearable
…experience comfort from a reduction in the level of pain or relief from pain
Intervention:
Acknowledge the patients pain and accept responses to pain
Allow alternative pain treatments from the patient’s culture, as appropriate
Assess the patients pain: characteristics, severity, location, onset, type, precipitation, factors and duration
Collaborate with patient about possible methods to reduce pain
Determine patients knowledge and beliefs about pain
Educate on ways to decrease factors precipitating to pain
Educate pt on what causes the pain and how long the pain is expected to last
Instruct pt to notify caregiver of all episodes of pain
Observe for nonverbal cues of discomfort: restlessness, muscle tension, altered VS
Schedule care activities to provide patient with uninterrupted periods of rest
Evaluation:
Pt identifies pain intensity on a pain scale and rate the pain consistently
Pt identifies factors that increase pain
Pt states and carries out ways to decrease pain
Pt notifies health care provider fo pain before it becomes unbearable to unmanageable
Pt experiences comfort from a reduction in the level of pain or relief
CHRONIC PAIN ADPIE
Assessment:
Sudden or slow onset of any intensity (mild-severe)
Constant or recurring without anticipatory predictable end
Duration greater than 3 months
Alteration in ability to continue previous activities
Alteration in sleep pattern
Anorexia
Evidence of pain using standardized pain behavior checklist for nonverbal pt’s
Family/Proxy report of pain behavior/activity changes
Self-focused
, Self-report of pain using pain scale; and characteristics using pain instrument
Diagnosis: Chronic pain related to…
Alteration in sleep pattern
Emotional distress
Fatigue
Increase in body mass index
Ineffective sexuality pattern
Injury agent
Malnutrition
Nerve compression
Prolonged computer use
Repeated handling of heavy loads
Social isolation
Whole-body vibration
Plan:
The patient will return to a previous activity level
…demonstrate signs of decreased pain
…verbalize relief or control of pain
…state an understanding of the prescribed medication regimen
Interventions:
Assess patients ability to complete ADL’s
Determine patient’s knowledge and beliefs about pain
Employ TX from pt’s culture, as appropriate, and monitor response
Encourage to verbalize pain and provide support
Explore diversional activities
Explore factors that relieve, worsen, or precipitate pain
Perform pain assessment
Provide uninterrupted periods of rest
Administer meds as prescribed, and monitor for effect
Apply heat and cold therapy, monitor effect
Pain management and physical therapy consults
Encourage participation in support groups
Treat underlying disorder
Evaluation:
Patient returns to a previous activity level
Pt demonstrates signs of decreased pain (relaxed facial expressions, posture)
Pt verbalizes pain is relieved or controlled
Pt states an understanding of prescribed medications
CROHN’S DISEASE ADPIE
Slow progressing
Starts anywhere in the GI tract
Most common in the terminal ileum and start of the colon
Affects ALL layers of mucosa to serosa; TRANSMURAL
Pain typically in RLQ
Moderate diarrhea
Assessment:
History
o Gradual onset of signs and symptoms
o Fatigue and weakness
o Chronic intermittent fever, flatulence, nausea
o Steady, colicky, or cramping abdominal pain that usually occurs in the RLQ
o Diarrhea that may worsen with emotional upset or foods not tolerated
Assessment:
Changes in appetite
Diaphoreses (sweating)
Vital signs changes, Elevated HR, BP, RR
Distraction behavior
Evidence of pain using standardized pain behavior checklist for those unable to communicate verbally
Expressive behavior, facial expressions
Guarding behavior
Positioning to ease pain
Pupil dilation
Self-report of pain using pain scale; characteristics using standardized pain instrument
Diagnosis: Acute pain related to…
Biological
Chemical
Physical
Plan:
The patient will identify pain intensity on a pain scale and rate the pain consistently
…identify factors that increase pain
…state and carry out ways to decrease the pain
…notify health care provider of pain before pain becomes unmanageable or unbearable
…experience comfort from a reduction in the level of pain or relief from pain
Intervention:
Acknowledge the patients pain and accept responses to pain
Allow alternative pain treatments from the patient’s culture, as appropriate
Assess the patients pain: characteristics, severity, location, onset, type, precipitation, factors and duration
Collaborate with patient about possible methods to reduce pain
Determine patients knowledge and beliefs about pain
Educate on ways to decrease factors precipitating to pain
Educate pt on what causes the pain and how long the pain is expected to last
Instruct pt to notify caregiver of all episodes of pain
Observe for nonverbal cues of discomfort: restlessness, muscle tension, altered VS
Schedule care activities to provide patient with uninterrupted periods of rest
Evaluation:
Pt identifies pain intensity on a pain scale and rate the pain consistently
Pt identifies factors that increase pain
Pt states and carries out ways to decrease pain
Pt notifies health care provider fo pain before it becomes unbearable to unmanageable
Pt experiences comfort from a reduction in the level of pain or relief
CHRONIC PAIN ADPIE
Assessment:
Sudden or slow onset of any intensity (mild-severe)
Constant or recurring without anticipatory predictable end
Duration greater than 3 months
Alteration in ability to continue previous activities
Alteration in sleep pattern
Anorexia
Evidence of pain using standardized pain behavior checklist for nonverbal pt’s
Family/Proxy report of pain behavior/activity changes
Self-focused
, Self-report of pain using pain scale; and characteristics using pain instrument
Diagnosis: Chronic pain related to…
Alteration in sleep pattern
Emotional distress
Fatigue
Increase in body mass index
Ineffective sexuality pattern
Injury agent
Malnutrition
Nerve compression
Prolonged computer use
Repeated handling of heavy loads
Social isolation
Whole-body vibration
Plan:
The patient will return to a previous activity level
…demonstrate signs of decreased pain
…verbalize relief or control of pain
…state an understanding of the prescribed medication regimen
Interventions:
Assess patients ability to complete ADL’s
Determine patient’s knowledge and beliefs about pain
Employ TX from pt’s culture, as appropriate, and monitor response
Encourage to verbalize pain and provide support
Explore diversional activities
Explore factors that relieve, worsen, or precipitate pain
Perform pain assessment
Provide uninterrupted periods of rest
Administer meds as prescribed, and monitor for effect
Apply heat and cold therapy, monitor effect
Pain management and physical therapy consults
Encourage participation in support groups
Treat underlying disorder
Evaluation:
Patient returns to a previous activity level
Pt demonstrates signs of decreased pain (relaxed facial expressions, posture)
Pt verbalizes pain is relieved or controlled
Pt states an understanding of prescribed medications
CROHN’S DISEASE ADPIE
Slow progressing
Starts anywhere in the GI tract
Most common in the terminal ileum and start of the colon
Affects ALL layers of mucosa to serosa; TRANSMURAL
Pain typically in RLQ
Moderate diarrhea
Assessment:
History
o Gradual onset of signs and symptoms
o Fatigue and weakness
o Chronic intermittent fever, flatulence, nausea
o Steady, colicky, or cramping abdominal pain that usually occurs in the RLQ
o Diarrhea that may worsen with emotional upset or foods not tolerated
