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 required. Therefore, it is compulsory for all nurses to possess 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 a proper treatment.
In the case study of an elderly man who actively participates in golf, pain assessment on his substernal chest pain should be conducted only by a qualified nurse. Pain assessment involves asking questions whereby the nurse and the patient enter into a form of dialogue. 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 first of all should be the most important for both the patient and for the doctors as they perform the diagnostic procedure.
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. The first question to the patient is 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 how long or rather the period of time the patient has experienced the pain. These may be minutes or hours. Moreover, the pain might be an on and off situation.
The third question is for the patient to 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 for the patient to briefly describe the pain to the nurse. This is necessary for documentation in the report. The fifth question is for the patient to explain which movements make the pain worse or relaxed. This helps the nurse determine which other parts of the body connect to the cause of pain. The sixth question is for the patient to say if the pain is bearable or not so that the nurse establishes the urgency of the patient’s pain management. The seventh question is to ask the patient the following question, since your childhood, have you ever felt any kind of pain in your chest; any if the answer is yes, and have you seen any doctor for treatment?
Finally, the last question the patient should be asked is whether the pain is permanent or seasonal. This question is very important for the doctors to understand the nature of pain hence come up with proper treatment. The above question provides a baseline to examine how the pain developed and the effect it has caused to the body of the patient. All questions are very important because excluding even one question will lead to unethical practice of nurses.
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 chief reason for a diagnosis is to help manage the pain of the patient by reducing the pain and assuring the patient is in comfort especially in such severe cases of 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.
“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 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 expertise of a nurse in assessing and managing pain must be a priority during a patient’s care in the hospital. 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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