TEACH FOR NURSES LESSON PLAN
Chapter 11: Pain Assessment
CHAPTER OBJECTIVES
1. Define pain.
2. Discuss the function of nociception and the patient’s sensation of pain.
3. Differentiate the different types of pain.
4. Compare acute and chronic pain.
STUDENT RESOURCES
understand
• Textbook Chapter 11
• Sherpath for Medical-Surgical Nursing*
• Animations (Evolve website)
• Answer Keys: Study Guide & Lab Manual
• Audio glossary (Evolve)
11-2
apply
• Case Studies (Evolve)
• Elsevier Adaptive Quizzing*
synthesize
• SimChart*
• Simulation Learning System*
INSTRUCTOR RESOURCES
before class
• Nursing Curriculum Standards (below)
in class
• Image Collection (Evolve)
• PowerPoint Presentations (Evolve)
* Sold separately from textbook.
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
NEUROANATOMIC
PATHWAY
NOCICEPTIVE PAIN
Explain the nociceptive
and neuropathic
processes.
• Discussion Topic: Have students discuss their memories of the worst pain they have experienced and
what relieved it.
11-3
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
Review the four phases of
nociception.
SOURCES OF PAIN
TYPES OF PAIN
DEVELOPMENTAL
COMPETENCE
Review visceral, deep
somatic, cutaneous, and
referred pain.
Explain the differences
between acute, persistent
(chronic), and
and nonmalignant.
Give examples of pain that
is sometimes undetected
in preverbal infants.
• Discussion Topic: Start a discussion of different methods used to relieve pain. Emphasize
nonpharmacologic strategies used to relieve pain.
• Online Activity: Have students research methods of pain relief used in different cultures. They can
either interview persons from different cultures or use the Internet to find information.
• Online Activity: Have students find a recent scholarly article on fetal pain. Discuss their findings in
class.
11-4
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
among them.
Invite three people who
are around the same age
SUBJECTIVE DATA
INITIAL PAIN ASSESSMENT
PAIN ASSESSMENT TOOLS
Discuss why the subjective
report is the most reliable
indicator of pain.
Emphasize that only the
patient can accurately
report levels of pain and
the nurse cannot compare
pain among patients.
• Activity: Have students use different pain assessment tools to rate pain, both while in the clinical
setting and even at home with family and friends.
11-5
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
Review the Oucher scale
and any other forms of
pain ratings for children.
MUSCLES AND SKIN
THE ABDOMEN
NONVERBAL BEHAVIORS
minimal distractions.
Demonstrate how to test
for location and extent of
altered sensation.
From your experience, give
examples of other
behaviors that indicate
chronic pain. Solicit
student input from the
students’ own personal or
familial experiences.
11-6
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
Discuss how sometimes it
is necessary to pause, be
still, and observe.
IN-CLASS/ONLINE CASE STUDY
J.P. is a 15-year-old African American adolescent who was diagnosed with sickle cell disease 3 years ago. J.P. presents to the emergency
department with pain related to sickle cell crisis.
Subjective Data
Pain level is an 8/10 location = bilateral legs, described as deep muscle pain
Objective Data
Vital signs: T 37 P 80 R 18 BP 140/68
Weight: 140
Height: 5 feet, 6 inches
Questions
1. What other assessments should be included for this patient?
2. Identify the various types of pain.
3. What type of pain does this patient describe?
4. What standards of assessing pain will be applied to this patient’s plan of care?
5. What teaching should the nurse consider from the problems list?
6. What interventions should be included in the plan of care for this patient?
11-7
Answers
1. Assess hydration status, stress level, presence of infection, activity level, what pain relief measures the patient has tried, and what measures
have been successful in the past. Assess nonverbal signs of pain. Assess pain level after medication administration to ensure the patient’s
comfort. Assess legs for discoloration, swelling, and ability to move.
2. Types of pain include acute, persistent (also called chronic), nociceptive, and neuropathic.
3. This patient has nociceptive, acute, and deep somatic pain.
4. The standards include (1) initial assessment and regular reassessment of pain, taking into account personal, cultural, spiritual, and ethnic
beliefs; (2) education of all relevant health care personnel in pain assessment and management; and (3) education of patients and families
regarding their roles in managing pain and the potential limitations and side effects of pain.
5. The teaching plan from the problems list might include the patient’s diet and exercise routine. Inquire about how often the patient
exercises. Rest and hydration are key factors for preventing sickle cell crisis.
11-8
6. Interventions should include being assertive with pain management, assessing and addressing hydration status, identifying family supports
for the patient in this crisis, incorporating culturally sensitive care, and identifying support groups for sickle cell disease. Assess the patient’s
immunization record to make sure immunizations are up to date. Encourage good handwashing and disease prevention. Assess patient’s
stress level and coping abilities.
NURSING CURRICULUM STANDARDS
QSEN/NLN COMPETENCIES
• Patient-Centered Care/Human Flourishing
o Neuroanatomic Pathway
NURSING CONCEPTS
The following conceptual themes and specific concepts match those presented in Giddens, J. F. (2017). Concepts for nursing practice (2nd ed.).
St. Louis: Elsevier. The specific exemplars chosen and listed below for each concept have been tailored specifically to correspond to the Jarvis
textbook.
A full Concept-Based Curriculum Map covering the entire book can be found in the “Download by Resource Type” folder on Evolve.
THEME: Mood and Cognition
• Concept: Cognition
11-9
o Exemplar: Neuropathic Pain
BSN ESSENTIALS
• Essential I: Liberal Education for Baccalaureate Generalist Nursing Practice
o Culture and Genetics
ANSWERS TO QUESTIONS IN THE STUDY GUIDE
Note: Answers to these questions can be found on Evolve site. Click here.