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Objective B – Discuss how to assess a patient experiencing pain.Name three commonly used pain scales in adults Pain ScalesReliable and valid pain intensity rating scales are used to measure and rank patients’ pain levels and help monitor pain trends over time. The numeric rating scale (NRS), the verbal descriptor scale, and the faces pain scale (FPS) are the three most common pain rating tools used in adults. The Wong-Baker FACES Pain Rating Scale is useful for assessing children, although children as young as 8 years can use a 0 to 10 number scale. Teaching patients to use reliable tools to communicate pain intensity helps them to maintain a sense of control and actively participate in their care.The pain intensity rating scale should be easy for the patient to use as well as age and culturally appropriate. It is important to remember that the intensity rating, based on the patient’s self-report, is always important yet should never be considered a complete pain assessment. The nurse should assess pain intensity by asking the patient directly to rate his or her pain at rest, before and after pain medications or interventions, and after activity. Remember that patients may still have pain while asleep.Nurses should not assume comfort and rate pain as a zero but instead should document sleep instead of a pain rating.Box 35-1is an example of how a nurse might educate and support a patient on the use of the numeric pain scale.Visual Analog Visual analogue scales (VAS) are useful in assessing the intensity of pain (Fig. 7-3, p. 198). One version of the scale includes a horizontal 10 cm line, with anchors (ends) indicating the extremes of pain. The patient is asked to place a mark indicating where the current pain lies on the line. The left anchor usually represents “none” or “no pain,” whereas the right anchor usually represents “severe” or “worst possible pain.” To score the results, a ruler is placed along the line, and the distance the patient marked from the left or low end is measured and reported in millimeters or centimeters.Some patients (e.g., children, elderly patients, visually or cognitively impaired patients) may find it difficult to use an unmarked VAS. In those circumstances, ordinal scales, such as a simple descriptive painintensity scale or a 0-to-10 numeric pain intensity scale, may be used.
Face Pain ScaleThe revised faces pain scale uses six facial expressions that range from contented to obvious distress (Fig.7-4, p. 198). The patient is asked to point to the face that most closely resembles the experienced pain intensity.Guideline for using Pain Assessment scalesUsing a written scale to assess pain may not be possible if a person is seriously ill, is in severe pain, or hasjust returned from surgery. In these cases, the nurse can ask the patient, “On a scale of 0 to 10, 0 being no pain and 10 being pain as bad as it can be, how bad is your pain now?” For patients who have difficulty with a 0 to 10 scale, a 0 to 5 scale may be tried. Whichever scale is used, it should be used consistently. Most patients usually can respond without difficulty. Ideally, the nurse teaches the patient