Pain Intervention Case Study

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Diagnosis 1: Acute pain related to surgical intervention evidenced by self reported pain

Chris appeared uncomfortable, with a grimacing facial expression, he verbalised a stabbing pain on his left knee with a pain score of 4 out of 10. When Chris’s pain worsens, to a pain score of 7 out 10, his respiratory rate increases to 22 breaths per minute and his heart rate increases to 86 beats per minute, scoring an EWS score of 1. Ackley, Ladwig, & Makic, 2016 explained that increase heart and respiratory rate are physiological changes related to pain.

Goals:
• Relieve Chris’s knee pain
• Chris feels comfortable and able to sleep properly

Nursing interventions:

Conduct a comprehensive pain assessment using OLDCARTS. The OLDCARTS pain assessment helps determine the onset, location, duration, characteristics, intensity and the alleviating and relieving factors of pain. Determining the factors of pain is critical in
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Upon assessment, Chris vital signs are now within the normal range however, he is still verbalising pain. Chris reported that there is a slight reduction of pain, from a pain score of 7, it is now 4 out of 10. After an hour, a second dose of analgesia was given to Chris and after 30 minutes another pain assessment was conducted. During the assessment Chris voiced out that he is comfortable and his pain score is now 1 out of 10, he also mentioned that before we came and checked up on him he was doing deep breathing exercises for 10 minutes, Chris said it helped him “soothes his body and reduce his pain.” These interventions are effective in managing Chris’s pain because his pain is now minimal and almost diminished compared to what he was experiencing before. To ensure that the goal is achieved, pharmacological and nonpharmacological interventions must be regularly implemented and

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