basic nursing question

[*Butterfly8*]

What do you document if your patient is unconscious and you need to put what their pain is from a scale of 1-10? there is not a place to put "unobserved".

[taz628, BSN, RN]

at our facility we have the option "unable to assign a number" and then we can choose "behavioral cues" and leave a comment or NVPS (non-verbal, paralyzed, sedated) as the scale type if we can't assign a number. This is, of course, with electronic charting (Epic to be exact).

[CABG patch kid, BSN, RN]

There are different pain scales that you can use for the unconscious patient, such as FLACC and Wong-Baker FACES. These scales use non-verbal cues such as grimacing, moaning, restlessness, etc. If the patient is sedated with something that doesn't have analgesic properties, such as Diprivan, but the patient is assumed to be in pain (post op for example), it is okay to document it as such, presume the pt to be in pain, and medicate him.

[vashtee, RN]

We use the FLACC scale which assigns a numeric value to various physical cues such as frowns, grimaces, legs restless, crying, etc. Like the numeric scale, 10 is the highest number possible.

[Havin' A Party!, ASN, RN]

Ditto above.