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Pain Assessment and Management

Pain is the fifth vital sign. Nurses assess pain systematically, believe the patient's report, and combine pharmacological and non-pharmacological management.

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Key Points to Know

What you must know about Pain Assessment

1

Pain is subjective — the patient’s self-report is the most reliable indicator.

2

Use assessment tools such as the numeric rating scale, visual analogue scale, or Wong-Baker faces.

3

The PQRST framework assesses Provocation, Quality, Region/Radiation, Severity, and Timing.

4

Combine pharmacological (analgesics) and non-pharmacological (positioning, distraction, warmth) methods.

5

Reassess pain after intervention to evaluate effectiveness.

6

Unrelieved pain can delay healing and cause physiological stress.

NMCN Exam Tips

How this topic appears in the NMCN exam

"Pain is what the patient says it is" — self-report is the gold standard.

Know the PQRST assessment mnemonic.

Always reassess pain after giving analgesia.

Use faces scales for children and those who cannot use numbers.

Practice Question

Test yourself

The MOST reliable indicator of a patient's pain is:

A.The patient's self-report of pain✓ Correct
B.The patient's blood pressure and pulse
C.The nurse's observation of facial expression
D.The type of surgery performed

Explanation

Pain is a subjective experience, and the patient's self-report is the single most reliable indicator. Vital signs and behavioural cues support assessment but may be normal even when pain is severe.

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