8. Pain Assessment
-
Upload
raditya-pangestu -
Category
Documents
-
view
216 -
download
0
Transcript of 8. Pain Assessment
-
7/25/2019 8. Pain Assessment
1/27
Pain Assessment
.ndrNur Surya Wirawan
-
7/25/2019 8. Pain Assessment
2/27
Pain is whatever the experiencing
person says it is, existing whenever
he or she says it does.
Margo McCaffrey, RN 1980
-
7/25/2019 8. Pain Assessment
3/27
Mantan Presiden APS Dr ames !amp"e##
menyata$an% tanda vital merupakan hal
yang sangat penting. ika nyeri dinilai
sama seperti tanda!tanda vital lainnya,
maka kita dapat mem"erikan pera#atan
yang le"ih "aik.
-
7/25/2019 8. Pain Assessment
4/27
Pain% &he 'i(th )ita# Sign*
Pu#se
+#ood pressure
&emperature
espiratory rate
Pain:The Fifth
Vital Sign
American Pain Society (APS) has redefned PAIN as the 5thvital sign Health care proessional has to assess patients or pain every time
-
7/25/2019 8. Pain Assessment
5/27
de(inition
Pain is an unp#easant sensory and
emotiona# experience associated with
actua# or potentia# tissue damage, or
descri"ed in terms o( such damage.
Pain is a#ways su"-ective
internationa# association (or the study o( pain /ASP 0
-
7/25/2019 8. Pain Assessment
6/27
-
7/25/2019 8. Pain Assessment
7/27
Ma-or goa# o( pain assessment is to use
the most appropriate diagnostic and
therapeutic considerations to de(ine its
cause and to direct its treatment
-
7/25/2019 8. Pain Assessment
8/27
pain history princip#es
See$ to esta"#ish a re#ationship with the
patient
1ncourage the patient to do most o( the
ta#$ing
+egin with a wide ang#e open 2uestion
"e(ore c#ari(ying and (ocusing with more
speci(ic ones
Watch the patient (or c#ues regarding pain
Avoid -umping to conc#usions
-
7/25/2019 8. Pain Assessment
9/27
+arrier in the assessment o( pain
&he mu#tidimensiona# nature o( the su"-ectivecomp#aint o( pain
&he #ac$ o( a c#ear#y de(ined #anguage o( pain
Poor communication "etween the patient andphysician a"out pain3 (or examp#e % 4nder5reporting "y the patient and under5
assessing "y the physician or nurse
-
7/25/2019 8. Pain Assessment
10/27
Pain Assessment
O nsetWhen did it "egin6 7ow #ong does it #ast6 7ow o(ten does it occur6
P recipitating8A##eviating 'actors% What "rings it on6 What ma$es it "etter6 What ma$es it worse6
Qua#ity o( Pain% As$ the patient to descri"e the pain using words #i$e sharp,
du##, sta""ing, "urning
Radiation Does pain exist in one #ocation or radiate to other areas6
Severity 7ave patient use a descriptive, numeric or visua# sca#e to rate
the severity o( pain.
-
7/25/2019 8. Pain Assessment
11/27
T reatment
What medications and treatments are you current#y
using6 7ow e((ective are these6 Do you have any sidee((ects (rom the medications and treatments6
4nderstanding /mpact on you05 activity% does it stop you doing this 6
5 s#eep%does it stop you s#eeping 6
5 mood% does it ma$e you unhappy or depressed6
)a#ue What is your goa# (or this symptom6 What is your com(ort goa# or
accepta"#e #eve# (or this symptom 9n a sca#e o( : to ;: with : "eing
none and ;: "eing worst possi"#e06 Are there any other views or
(ee#ings a"out this symptom that are important to you or your
(ami#y6
-
7/25/2019 8. Pain Assessment
12/27
1ach pain needs a separate assessment
-
7/25/2019 8. Pain Assessment
13/27
-
7/25/2019 8. Pain Assessment
14/27
&o measure pain intensity or severity
Use Pain Scores
-
7/25/2019 8. Pain Assessment
15/27
-
7/25/2019 8. Pain Assessment
16/27
A#at peni#aian nyeriSu"ye$ti(
Numeric ating Sca#e
Sca#e )er"a# Descriptor
Sca#e )isua# Ana#og
'aces Pain Sca#e
-
7/25/2019 8. Pain Assessment
17/27
Pain Assessment Tools:Wong-Baker
-
7/25/2019 8. Pain Assessment
18/27
-
7/25/2019 8. Pain Assessment
19/27
Pain Assessment Tools:Non5)er"a# Pain Sca#e '>A!!0
"h A t $ l
-
7/25/2019 8. Pain Assessment
20/27
Patient
ale to
comm#nicate
!ell
N8
&%S
"hoose o Assessment $ools
>aces painassessment
scale(>ig A)
V7S painassessment
scale(>ig ;)
N7Sassessment
scale(>ig ")
VASassessment
scale(>ig :)
No pain ?ittle pain 3edi#m pain ?arge pain 4o possile pain
>ig ; V7S@
2 ' * + , 5 - . / 0
>ig " N7S'
3oderate painNo Pain4orst
possile pain
Vis#al analog#e scale (VAS)>ig : VAS'
No pain 4orstpossile pain
' adapted rom 3c"aery 3B pasero " painC "linical 3an#al '000 !ith permission rom %lsevier@ 4ith permission rom %lsevier
>ig A 4ongD;aer aces Pain 7ating Scale@
2 ' * + , 5No h#rt H#rts
?ittle itH#rts
?ittle moreH#rts
%ven moreH#rts
4hole lotH#rts4orst
Alternativecoding2 * , - / '
-
7/25/2019 8. Pain Assessment
21/27
!/&/!A> !A1 PA/N 9+S1)A&/9N &99>
-
7/25/2019 8. Pain Assessment
22/27
3I?: 38:%7A$% S%V%7%
-
7/25/2019 8. Pain Assessment
23/27
Pain Se&erit'
?uides urgency o( treatment
?uides type o( drug on the W79 >adder
which is #i$e#y to "e e((ective
-
7/25/2019 8. Pain Assessment
24/27
&hree Step >adder W79,
;@B$ essential
concepts
%y mouth
%y the clock
%y the ladder
%y individual
&ith attention to
detail
+y this moda#ity C @: o( cancer pain can "ere#ieved
-
7/25/2019 8. Pain Assessment
25/27
important princip#es assessment o( pain
Accept the patientEs descriptionAssess the pain care(u##y
7istory
1xamination
/nvestigation
Assess each painAssess the extent o( the patientEs diseaseAssess the other (actors which may in(#uence pain
Physica# F psycho#ogica# F socia# F cu#tura# 5 spiritua#
eassess
-
7/25/2019 8. Pain Assessment
26/27
reassessment
epeated review is important
/ncorrect diagnosis 6
9ther (actors, eg. Depression 6
-
7/25/2019 8. Pain Assessment
27/27
Tanks "or (istening
?ie is