1-7. NURSING ASSESSMENT OF ORTHOPEDIC PAIN

a. When assessing and evaluating the patient's pain, you should make the following determinations.

(1) What was the patient doing before the pain began? How did it begin?

 

(2) How does the patient describe the pain? Is it localized? Does it radiate? Is it continuous or intermittent?

 

(3) What is the character of the pain? Is it sharp, dull, piercing, shooting, cramping, or throbbing?

 

(4) What relieves the pain? What makes it worse?

 

(5) Is the patient's body in proper alignment?

 

(6) Is the patient experiencing pressure from casts, splints, traction, or other objects?

 

(7) What is the status of the circulation, sensation, and motor function in the affected area now as compared to previous checks?

b. Careful assessment and evaluation of the patient's pain will allow the nursing staff to determine the appropriate nursing intervention required. The nursing management might involve such actions as repositioning the patient, support or elevation of affected limbs, application of heat or cold, or the administration of analgesics, sedatives, or muscle relaxants as ordered by the physician.

(1) Repositioning. If the patient's body is out of alignment or a limb has moved to an abnormal position, all that may be required is to realign the body or reposition the affected limb. Proper body alignment is a key factor in patient comfort.

 

(2) Support. An affected limb may require support or elevation on pillows in order to reduce swelling and reduce strain on the associated musculature.

 

(3) Circulation. Application of heat or cold is useful in promoting circulation and reducing swelling.

 

(4) Medication. Prescribed medications such as analgesics, sedatives, and muscle relaxants are administered to control pain. (Other nursing measures should be utilized prior to administering medication since relief of pain may be achieved by using one of the simple nursing measures listed above.)