Acute pain is defined as an unpleasant emotional and sensory experience. It is most often associated with damage to the body’s tissues. The onset of acute pain can be slow or sudden. The main difference between acute and chronic pain is that acute pain has an anticipated resolution, with the pain lasting less than three months.
Causes
The most common cause of acute pain is damage to the body tissues. This can be related to three different types of injury agents; physical, biological or chemical. Acute pain can also be related to psychological causes or exacerbations of existing medical conditions.
- Biological injury agents include bacteria, viruses, and fungi that harm the body and cause pain.
- Chemical injury agents are typically caustic and can cause harm in a variety of ways.
- Physical injury causes pain you normally think of when someone is hurt, such as a broken bone, laceration, or following a surgical procedure.
Signs and Symptoms
Some signs of pain are easy to recognize, such as verbal reports from the patient, expressions of pain such as crying, or significant changes in vital signs. Other manifestations of acute pain can be more difficult to spot. These types of signs could include changes in appetite or eating patterns, changes in sleep patterns, and guarding or protective behaviors to avoid aggravating a painful area.
Assessment
When assessing pain it is important to use the standard protocols for assessing and documenting pain and responses to intervention. It is also important to use the most appropriate pain scale available for each patient.
Assessments of pain should be thorough to identify any underlying complications that may be causing unexpected amounts of pain. For instance, pain related to swelling and inflammation near a surgical site should be evaluated for the possibility of infection or compartment syndrome.
Nursing Care Plans for Acute Pain
The following are four example nursing care plans for caring for a patient in acute pain.
Acute pain care plans should always be individualized to the patient. The care planning process should assess contributing factors to the patient’s pain, the appropriateness of the planned interventions, and effective methods for evaluating the patient’s response.
Nursing Care Plan 1
Nursing Diagnosis: Acute pain related to orthopedic surgical procedure of the left lower extremity as evidenced by heart rate 112 bpm, guarding of the left lower extremity, and reports of pain from the patient, rating pain a 8 on a scale of 1/10.
Desired Outcome: Within 4 hours of nursing interventions, the patient will report pain reduced to a 4/10 or less.
| Intervention | Rationale |
| Assess the patient’s comfort level with non-pharmacological methods of pain relief . | Some patients are unaware that non-pharmacological methods can be used with or instead of analgesic drugs. A more effective reduction in pain can be achieved using a combination of these therapies. |
| Determine and administer the appropriate prescribed analgesic. | Analgesic drugs like NSAIDS, opioids, and local anesthetics pharmacologically reduce acute pain quickly and effectively. |
| Assess the appropriateness of a PCA pump if the patient is a PCA candidate. | PCA is the IV infusion of opioids through a pump controlled by the patient. If the patient meets the criteria this can be a more effective method of pain management. |
| Reassess pain level after 30 minutes of interventions. | It is important to reassess pain following interventions to determine if those actions were effective, and the patient’s pain control goals have been met. |
| Educate the patient regarding effective timing of medication doses prior to activities that exacerbate pain and to avoid periods of intense pain. | Patients can help effectively manage their pain with additional knowledge of when to request pain medication to maximize its effectiveness and prevent severe pain episodes. |
Nursing Care Plan 2
Nursing Diagnosis: Acute pain related to acute bronchitis as evidenced by patient reports of chest and throat soreness, lack of appetite, and grimacing while coughing and speaking.
Desired Outcome: Within 2 hours of nursing interventions, the patient will verbalize reduced chest and throat soreness.
| Intervention | Rationale |
| Assess pain characteristics (quality, severity, location, onset, duration, precipitating and relieving factors) | Accurately assessing the patient’s pain is the first step to planning effective pain management. |
| Administer antitussive medication PRN as prescribed to eliminate sources of discomfort. | Antitussive medications when indicated can help suppress coughing and provide relief from painful stimuli. |
| Instruct the patient to assess the effectiveness of the interventions used and report them to the care team. | Feedback can assist the care team in modifying and improving pain control strategies. |
Nursing Care Plan 3
Nursing Diagnosis: Acute Pain related to psychological distress as evidenced by patient verbalizing pain, moaning and crying, narrowed focus and altered passage of time, and pallor.
Desired Outcome: Within 4 hours of nursing interventions, the patient will demonstrate a reduction in crying and pain verbalization.
| Intervention | Rationale |
| Assess to what extent cultural, environmental, intrapersonal, and intrapsychic factors may be contributing to pain. | These influences alter the patient’s expression of the pain experienced. This assessment can be used to evaluate each patient’s unique response. |
| Respond immediately to reports of pain. | If the patient is experiencing an altered passage of time due to pain, fear about delayed pain relief can exacerbate the pain experience. Prompt responses to reports of pain reduce anxiety and promote trust. |
| Promote periods of rest for the patient. | Fatigue can contribute to pain. A quiet, darkened room with minimal noise and interruptions can promote rest and reduce pain. |
| Use relaxation and breathing exercises and/or music therapy. | These techniques help produce a sense of tranquility for the patient. The goal is to reduce pain related to tension or stress. |
Nursing Care Plan 4
Nursing Diagnosis: Acute pain related to chemical burns on back as evidenced by patient reports burning pain rated 6/10, restlessness when lying down, and antalgic positioning to avoid pressure on back.
Desired Outcome: Within 4 hours of nursing interventions, the patient will report pain 3 or less and ability to rest in bed.
| Intervention | Rationale |
| Assess the patient’s expectations for pain relief. | Some patients are satisfied with a reduction of pain, while others desire it to be completely eliminated. Discussing their expectations can affect their perception of the effectiveness of their pain control and willingness to participate in treatment. |
| Moving attention away from the painful stimuli by using effective distractors can reduce the amount of pain perceived by the patient. | Provide appropriate and engaging distraction for the patient to redirect their attention. Moving attention away from the painful stimuli by using effective distractors can reduce the amount of pain perceived by the patient. |
| Give analgesics as ordered, evaluating their effectiveness and observing for side effects. | Drugs have varying effects based on each person’s metabolism and efficacy should be evaluated on a case-by-case basis. Monitoring for side effects is also important to maintain the patient’s comfort and safety. |
| Anticipate the need for pain relief. | Pain is most effectively managed by preventing it. Intervening early can decrease the total amount of analgesic needed to provide adequate pain control. |
References and Sources
- “Acute Bronchitis.” Johns Hopkins Medicine, Johns Hopkins Medicine, https://www.hopkinsmedicine.org/health/conditions-and-diseases/acute-bronc.
- “Biological Agents – Overview.” Occupational Safety and Health Administration, United States Department of Labor, https://www.osha.gov/biological-agents.
- Doenges, Marilynn E., et al. Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care. F.A. Davis, 2005.
- Gulanick, Meg, and Judith L. Myers. Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier/Mosby, 2014.
- Herdman, T. Heather, and Shigemi Kamitsuru. Nursing Diagnoses: Definitions and Classification 2018-2020. Thieme, 2018.
