Nursing Diagnosis for Chronic Pain

Victor
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NANDA Definition: Unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage (International Association for the Study of Pain); sudden or slow onset of intensity from mild to severe; constant or recurring without an anticipated or predictable end and a duration of greater than 6 months

Chronic pain may be classified as chronic malignant pain or chronic nonmalignant pain. In the former, the pain is associated with a specific cause such as cancer. With chronic nonmalignant pain the original tissue injury is not progressive or has been healed. Identifying an organic cause for this type of chronic pain is more difficult.

Chronic pain differs from acute pain in that it is harder for the patient to provide specific information about the location and the intensity of the pain. Over time it becomes more difficult for the patient to differentiate the exact location of the pain and clearly identify the intensity of the pain. The patient with chronic pain often does not present with behaviors and physiological changes associated with acute pain. Family members, friends, coworkers, employers, and health care providers question the legitimacy of the patient’s pain complaints because the patient may not look like someone in pain. The patient may be accused of using pain to gain attention or to avoid work and family responsibilities. With chronic pain, the patient’s level of suffering usually increases over time. Chronic pain can have a profound impact on the patient’s activities of daily living, mobility, activity tolerance, ability to work, role performance, financial status, mood, emotional status, spirituality, family interactions, and social interactions.


NOC Outcomes (Nursing Outcomes Classification)
Suggested NOC Labels

  • Pain Control
  • Quality of Life
  • Family Coping

NIC Interventions (Nursing Interventions Classification)
Suggested NIC Labels

  • Pain Management
  • Medication Management
  • Acupressure
  • Heat/Cold Application
  • Progressive Muscle Relaxation
  • Transcutaneous Electrical Nerve Stimulation (TENS)
  • Simple Massage

Defining Characteristics:
  • Weight changes
  • Verbal or coded report or observed evidence of protective behavior, guarding behavior, facial mask, irritability, self-focusing, restlessness, depression
  • Atrophy of involved muscle group
  • Changes in sleep pattern
  • Fatigue
  • Fear of reinjury
  • Reduced interaction with people
  • Altered ability to continue previous activities
  • Sympathetic mediated responses (e.g., temperature, cold, changes of body position, hypersensitivity)
  • Anorexia

Related Factors:
  • Chronic physical or psychosocial disability

Expected Outcomes
  • Patient verbalizes acceptable level of pain relief and ability to engage in desired activities.

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