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Core Principles of Pain Assessment Cheat Sheet (DRAFT) by [deleted]

Core Principles of Pain Assessment

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Core Principles of Pain Assessment

Every older adult has the right to approp­riate assessment and management of pain. Pain should be assessed in all indivi­duals living in nursing homes.
Pain is always subjec­tive. Therefore, the indivi­dual's self-r­eport of pain1 is the single most reliable indicator of pain. The clinician needs to accept and respect this self-r­eport.
Physiological and behavioral (objec­tive) signs of pain (e.g., tachyc­ardia, grimacing) are neither sensitive nor specific for pain. Such observ­ations should not replace individual self-r­eport unless the individual is unable to commun­icate.
Assessment approa­ches, including tools, must be approp­riate for the indivi­dual. Special consid­era­tions are needed for those with difficulty commun­ica­ting. Family members should be included in the assessment process, when possible.
Pain can exist even when no physical cause can be found. Thus, pain without an identi­fiable cause should not be routinely attributed to psycho­logical causes or discou­nted.
Different levels of pain in response to the same stimulus may be experi­enced by indivi­duals; that is, a uniform pain threshold does not exist.
Pain tolerance varies among and within indivi­duals depending on factors including heredity, energy level, coping skills, and prior experi­ences with pain.
Individuals with chronic pain may be more sensitive to pain and other stimuli.
Unrelieved pain has adverse physical and psycho­logical conseq­uences. Therefore, clinicians should encourage the reporting of pain by indivi­duals who are reluctant to discuss pain, deny pain when it is likely present, or fail to follow through on prescribed treatm­ents.
Pain is an unpleasant sensory and emotional experi­ence, so assessment should address both physical and psycho­logical aspects of pain.
Adapted from: Ersek M, Polomano RA. (2011). Nursing management of pain. (In) Lewis SM, Heitkemper MM, Dirksen SR, O’Brien P, Giddens J, Bucher L. (Eds.) Medica­l-S­urgical Nursing: Assessment and Management of Clinical Problems, 8th Edition. Philad­elphia: Elsevier.
 

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