The nurse is caring for a cognitively impaired client who has experien

The nurse is caring for a cognitively impaired client who has experienced a painful procedure. The nurse is most effective in determining the client’s pain medication needs when using which of the following assessment methods?

1. Medicating the client with the as-needed (prn) analgesic as often as ordered
2. Utilizing the pain face scale to assess the client’s pain experience
3. Asking the client to rate his or her pain on a scale of 1 to 10, with 10 being the most severe pain
4. Observing the client’s body movements and facial expressions for typical pain behaviors

ANSWER

ANS: 4
Body movements and facial expressions that indicate pain include clenching the teeth, holding the painful part, bent posture, and grimaces. Some clients cry or moan, are restless, or make fre-quent requests of a nurse. You will soon learn to recognize patterns of behavior that reflect pain. This becomes especially important in clients who are unable to report their pain, such as the cog-nitively impaired. However, lack of pain expression does not necessarily mean that the client is not experiencing pain. The remaining options are not always as effective for the cognitively im-paired or reflect inappropriate use of analgesics.