Date Identified:

Date Evaluated:

Cues Nursing Diagnosis Planning Interventions Rationale Evaluation

1.Assess Vital Signs 1.Actual Pain alters vital signs

2.Relate patient’s pain to pain 2.To assess pain’s severity

scale.

3.3.Assess significant cues 3.To confirm patient’s

indicative to pain e.g. verbalization to pain
grimacing

4.Position the client 4.Positioning properly lessens

comfortably that causes no pain sensation of the
pain patient

5. Elevate patient’s amputated 5.This is to decrease swelling

leg. that also causes pain

6.Instruct patient to do deep 6.To prevent fatigue that

breathing exercise intensifies pain sensation felt
by the patient
7.Encourage patient to do 7.To relief pain
diversional activity like relaxing

8. Provide comfort measures 8.To provide pain relief

like cold compress
9. Provide adequate rest 9.To prevent fatigue that
periods intensifies
10.Provide relieving 10. To relief pain felt by the
interventions like therapeutic client
touch