Hi, All!I am a student in an LPN program, end of my 2nd quarter out of 5 quarter program.I am working on an essay question for a self-study take home test. One of the questions asks how I would assess a patient with post/op pain in order to understand their level of distress. I've read the chapter on pain, and I understand all about the 1-10 pain rating scale. What other particular questions should I ask? "Where is it located? Can you describe it? Is it constant? Sharp/dull?" What else? I tried searching this web site, but couldn't find any questions to ask the patient (nor on Google). I have to turn this test in next Monday. (Dec. 3, I think). Any words of wisdom would be greatly appreciated!Thank you!
emtb2rn, BSN, RN, EMT-B 2,939 Posts Specializes in Emergency. Has 21 years experience. Nov 27, 2007 I like to use the OPQRST protocol, it gives a pretty good picture:Onset - What were you doing when the pain started? Did the pain come on suddenly or gradual?Provocation - does anything make the pain go away? Does anything make it worse?Quality - how would you describe the pain? Is it pain or pressure? Is it steady? (try not to put words in the pts mouth, let them describe the sensation).Radiation - Does the pain move? Where does it hurt the most? (Pointing with one finger is a good way to get specificity).Severity - the 1-10 scale. Ask how it feels now and how it felt when the pain began.Time - when did the pain start? Ever feel anything like this before? (If yes, find out what happened).Modify as necessary depending on the situation.G'luck.
PsychNurseWannaBe, BSN, RN 747 Posts Specializes in LTC, Nursing Management, WCC. Has 15 years experience. Nov 28, 2007 Also, when using the pain scale, many people will say that the goal should be... "patient reports a level 3 or less." But it should be what the patient considers to be adequate. Pain is subjective, therefore a "3" is not a standard concept. I would mention something to that effect.
mcknis 977 Posts Specializes in Med Surg, ER, OR. Nov 28, 2007 Also, don't forget to follow-up to make sure that pain has decreased after administering a pain medication!
MrsRNn2009 46 Posts Specializes in Pediatric CVICU. Nov 28, 2007 sometimes pain occurs when doing something. be sure to ask when the pain began & what the pt was doing with this pain occured. if the pain is reproducible then what relieves the pain, is it meds, destraction, repositioning or what. you can also ask how frequently the pain comes & goes, this can help you prepare a med & give them the pain med before they are @ a 6/10 or whatever. the goal should be to minimize the discomfort of the pt.
studentnurse67 67 Posts Nov 28, 2007 I like to use the OPQRST protocol, it gives a pretty good picture:Onset - What were you doing when the pain started? Did the pain come on suddenly or gradual?Provocation - does anything make the pain go away? Does anything make it worse?Quality - how would you describe the pain? Is it pain or pressure? Is it steady? (try not to put words in the pts mouth, let them describe the sensation).Radiation - Does the pain move? Where does it hurt the most? (Pointing with one finger is a good way to get specificity).Severity - the 1-10 scale. Ask how it feels now and how it felt when the pain began.Time - when did the pain start? Ever feel anything like this before? (If yes, find out what happened).These are great questions--thanks so much for your help!Laurel
Conrad283, BSN, RN 338 Posts Specializes in SICU, MICU, CICU, NeuroICU. Nov 28, 2007 You can use the FLACC scale, if they're non-verbal.
PsychNurseWannaBe, BSN, RN 747 Posts Specializes in LTC, Nursing Management, WCC. Has 15 years experience. Nov 28, 2007 Also, don't forget to follow-up to make sure that pain has decreased after administering a pain medication!Good point. We have to reassess one hour after administration.
mcknis 977 Posts Specializes in Med Surg, ER, OR. Nov 28, 2007 You can use the FLACC scale, if they're non-verbal.There are many other scales besides this one to determine pain in non verbal pts. This one is probably the most used though.
onyx77 404 Posts Nov 29, 2007 Another one in addition to the PQRST that We were taught is 'OLD CART'O- onsetL- locationD- durationC- characteristicsA- aggravating and allieviating factorsR- radiationT- time pain started
studentnurse67 67 Posts Nov 29, 2007 Another one in addition to the PQRST that We were taught is 'OLD CART'O- onsetL- locationD- durationC- characteristicsA- aggravating and allieviating factorsR- radiationT- time pain startedThank you! I have to turn in my test on Monday and will make some updates this weekend!Laurel
