CUES Objective: Grimacing face Irritable Guarding behavior Pain scale of 8/10.

GOALS After 12 hours shift, pain will be lessened. After 5 minutes, will be able to verbalize the characteristic and location of pain. After 10 minutes, will be able to perform pain management: - deep breathing techinique.

NURSING INTERVENTION Encourage verbal report during and after nursing interventions. Assess pain scale and perception. Monitor v/s and pain scale. Teach patient about diversional activities. Teach deep breathing. Placed to comfortable position. -

RATIONALE Pain is a subjective experience and must be described by the client in order to plan effective treatment. This is also to identify the intensity, onset, duration, and quality of the pain. Obtain v/s. v/s changes during onset of pain, for future comparison after interventions. To divert clients attention from pain. To allow proper o2 supply in the body, client tend to stop breathing during pain. Lessen pain through comfort. Relieve the client of pain using pharmacologic intervention.

EVALUATION

Tramadol and morphine -

-acute pain related to post-op surgical incision Cause ana-External and internal factor aggravates the nerve endings in the lower extremity causing production of prostaglandin, bradykinin, histamine, and progesterone to react on the specific region causing pain sensation felt by the client. - Pain is a typical sensory experience that may be describe as the unpleasant awareness of a noxious stimulus or bodily harm. Individuals experience pain by various daily hurts and aches, and occassionaly through more serious injuries or illnesses.(wiki)