Acute pain R/T tissue ischemia

Expected Outcomes
Child will be free of severe and constant pain as evidence by verbal communication of comfort, lack of facial grimacing, lack of restlessness, rating of decreased pain or no pain on pain assessment tool

Nursing Interventions
Assess and record any signs/symptoms of pain every 2 to 4 hours and PRN. Use age appropriate pain assessment tool.

Scientific Rationale

Evaluation

Revisions
Continue care plan.

Provide data regarding the Within 2 hours pain level of pain child is decreased from 9/10 to experiencing. 7/10 Goal has not been met

Handle patient gently. Reposition , immobilize the painful area as indicated. When indicated , ensure that bed rest is maintained .Do not disturbed child unless necessary. Administer pain Medication (Motrin 400mg Dilaudid 2mg, Percocet 2tabs as ordered on schedule. Assess and record effectiveness.

Helps to minimize pain and promote comfort.

Child was handle gently and pain did not decrease. Pain scale 7/10 Goal has not been met pain did not subside per patient pain scale 7/10 Goal has not been met Patient verbalizes no pain Goal has been met

Revise care plan

Helps to promote comfort, decrease pain and decrease oxygen expenditure. Analgesics and narcotics are administered to decrease pain. NSAID provide added pain relief.

Revise care plan

No revision needed

Acute pain R/T tissue ischemia

Administer fluids as indicated, both oral and parental. Keep accurate record of intake and output. When indicated , institute additional pain relief measures, such as application of moist heat, massage or guided imagery. Assess and record effectiveness.

Provides information on childs hydration status. Adequate hydration helps avoid sickling episodes. Hemodilution helps decrease the effects of sickled cells. These nonpharmacologic measures may help decrease pain.

patient verbalized comfort/no pain

D/C care plan

Patient is c/o pain Pain scale 7/10

Revise care plan