Nursing Interventions:
1. Assess pain severity on scale of 1-10.
2. Offer pain medicine q4 per
physician order.
3. Reposition patient every 2 hours
beginning 8 AM.
4. Direct and educate patient on
muscle relaxation techniques to help manage pain.
5. Reduce environmental factors,
such as noise, in patient room.
|
Rationale:
1. Assessment provides baseline.
2. Medication will help maintain
patient comfort.
3. Repositioning helps in prevention
of pressure ulcers and aids in comfort.
4. Relaxation techniques help with
self -control when pain develops.
5. Pleasurable sensory stimuli
reduce pain perception.
|
Client Response:
1. Patient states pain is 3 on pain
scale.
2. Patient is maintaining a level of
3 on the pain scale.
3. Client remains free of pressure
ulcers and is able to reposition with assistance.
4. Patient listened and was able to
demonstrate understanding of breathing exercises.
5. Patient requested door be kept
closed to reduce noise and lighting to be at a minimum.
|