Assessment Diagnosis Planning Intervention
Acute back pain After 8 hours of Independent:
related to pressure nursing -Assessed pain,
on lumbar nerve interventions, character,
endings secondary the location, severity,
to enlargement of patient will be and duration; used
the outpouching able to a pain rating
abdominal aortic experience scale.
aneurysm gradual - Accepted client’s
reduction / relief description of
of pain from a pain. Acknowledged
pain scale of 8 the pain experience
to at least 4. and convey
acceptance of
client’s response
to pain.
- Monitored v/s
every 4hrs.
- Review client’s
previous
experiences with
pain and methods
found in the past.
- Teach client and
significant other about the
non-pharmacologic ways
to lessen the pain.
Rationale Evaluation
- Pain assessment
can provide clues
about diagnosis, and
be used to determine
treatment required
- Pain is subjective
experience and
cannot be felt by
others.
- Slight increase of
RR could be resulted
from the possibility
of patient’s
reaction towards
pain.
- May be helpful for
management pain
control.
- To maximize opportunities
for self-control over pain
manifestations.
- Instruct client to report - Only the client can
any judge the level and
improvement/exacerbation distress of pain. This is to
in pain experience. provide appropriate nursing
intervention if necessary.
Dependent:
- Administer medications,
particularly analgesics, as
prescribed.