Pain Assessment - Health Assessment for Nursing Students | @LevelUpRN

Summary

In this video, Meris explains how to perform a comprehensive pain assessment using the OLD CARTS method, covering key components such as onset, location, duration, characteristics, aggravating factors, relieving factors, treatment, and severity. She also reviews various pain scales, including CRIES for infants, FLACC for young children, and the Wong-Baker FACES scale for those aged 3 and above. Emphasizing the importance of understanding each patient's pain experience, Meris underscores the need for critical thinking when assessing pain in patients with chronic pain or those on long-term medication, advocating for a personalized approach to pain management.

Takeaways

• 😀 OLD CARTS is a helpful acronym for remembering the components of a pain assessment: Onset, Location, Duration, Characteristics, Aggravating Factors, Relieving Factors, Treatment, and Severity.
• 😀 The assessment of pain should include understanding the onset of pain (when it started) and its location (where it hurts), with a helpful technique being asking the patient to point to the pain with one finger.
• 😀 Duration refers to whether the pain is constant or intermittent. This is different from onset, which simply tracks when the pain started.
• 😀 Characteristics of pain involve asking patients to describe how the pain feels, with examples like aching, stabbing, throbbing, shooting, or burning, which can indicate the type of pain (nociceptive vs neuropathic).
• 😀 Aggravating and relieving factors should be explored, including whether any actions or conditions make the pain worse or better.
• 😀 Radiation refers to whether the pain spreads or moves to other parts of the body. For example, substernal chest pain might radiate to the jaw or arm, which is critical for diagnosing specific conditions.
• 😀 Treatment history provides insight into what has been tried to relieve the pain, indicating how severe the problem is if none of the treatments have worked.
• 😀 Severity is measured using pain scales, where patients rate their pain on a scale from 0 to 10, and the nurse records the pain intensity as reported by the patient.
• 😀 Pain scales like CRIES (for infants) and FLACC (for children under 7) help assess pain in non-verbal or young patients by observing physical behaviors like crying or leg movements.
• 😀 The Wong-Baker FACES scale is commonly used for children 3 years and older who can point to a face that represents how much pain they feel, instead of using numerical pain scales.
• 😀 When assessing pain in patients with chronic pain or those on long-term medications (like opiates), it's important to consider their baseline pain and how they may respond differently to pain treatments than those without chronic pain.

Q & A

What is the key method for remembering the components of a pain assessment?

The key method for remembering the components of a pain assessment is OLD CARTS, which stands for Onset, Location, Duration, Characteristics, Aggravating factors, Relieving factors, Treatment, and Severity.

What does the 'O' in OLD CARTS represent, and how should it be assessed?

'O' represents Onset, which refers to when the pain started. The nurse should ask the patient if the pain started recently or has been ongoing for a long time.

Why is it important to ask patients to show where it hurts using one finger?

Using one finger helps patients specifically point to the area of pain, providing clearer information and preventing confusion about the exact location of discomfort.

What does 'C' for Characteristics in OLD CARTS ask, and how should it be approached?

'C' stands for Characteristics, which asks the patient to describe what the pain feels like. The nurse can prompt with examples like aching, stabbing, or throbbing to help the patient describe the pain.

What is the purpose of asking about aggravating and relieving factors during a pain assessment?

The purpose is to understand if anything makes the pain worse or better. This helps in identifying triggers and potential treatments to manage the pain.

How is 'Radiation' assessed during a pain evaluation?

'Radiation' refers to whether the pain spreads to other areas of the body. The nurse should ask the patient if the pain moves anywhere else, such as to the jaw or down the arm.

What is the significance of assessing the 'Treatment' of a patient's pain?

Assessing Treatment helps the nurse understand what the patient has tried to relieve the pain and whether these methods were effective. It also provides insight into the severity and chronic nature of the pain.

How should the severity of pain be rated according to the transcript?

Pain severity should be rated on a scale from 0 to 10, where 0 means no pain and 10 represents the worst pain the patient has ever experienced.

What pain scales are appropriate for children, and what ages are they designed for?

The CRIES scale is used for children less than or equal to six months, and the FLACC scale is used for children between two months and seven years. The FACES or Wong-Baker scale is used for children aged three years or older.

Why is it important to treat patients' pain according to their own report, rather than making assumptions based on their appearance?

It is crucial to treat patients' pain based on their own report because their experience of pain is subjective. Just because a patient appears calm or has normal vital signs does not mean they are not in severe pain.