English for Nursing 1

Topic 7
Name : Irma Nurul Aeni
Class : 2A PSIK
Nim : 1020031081

QUESTIONING TO FILL IN A PAIN ASSESSMENT FORM

Instructional objective
The students are expected to be able:
1. to make questions to fill a pain assessment form, and
2. to act out an interview to fill a pain assessment form.

Reading
Direction. Read the text below. Use the pain assessment form for your communication practice.

Initial Pain Assessment

When patients are admitted to a health care facility, such as a hospital or an outpatient
clinic, nurses perform general admission assessments. Along with such information as
the patient’s self-care abilities and nutritional needs, a section should be included to
identify pain problems. Patients may have chronic pain conditions for which they are
already receiving treatment, or pain may be the primary reason for admission.
Initial Pain Assessment Tool
The Initial Pain Assessment Tool may be completed by the patient or used to guide the
clinician in collecting information about the patient’s pain. A discussion of each
assessment point follows.
1. Location of pain. This is most easily and quickly accomplished by asking the patient to
mark the location on the figure drawings. Alternately, the clinician may ask the patient to
point to the locations of pain on his or her own bodies, and the clinician can mark figure
drawings. If there is more than one site of pain, letters (A, B, C, etc.) may be used to
distinguish the various sites. These letters may be used in answering the remainder of
the questions.
2. Intensity. The pain rating scale used by the patient is identified. The patient is asked to
rate pain intensity for present pain, worst pain, the least pain felt, and comfort-function
goals (pain rating that will not interfere with necessary or desired functioning, such as
ambulation and decreased anxiety). If the patient has more than one site of pain, the letter
designations mentioned simplify recording. For example, for present pain intensity, the
recording might be A = 4, B = 6. A time period may be specified for answering the next

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questions about pain intensity. For example, worst pain intensity may be asked in relation
to the past 24 hours or the past week.
3. Is this pain constant? If not, how often does it occur? These questions help screen for the
presence of breakthrough pain (BTP), defined as a transitory increase in pain that occurs
on a background of otherwise controlled chronic pain. If the patient says the pain is
constant, this rules out BTP. But if the patient say the pain is not constant, further
questioning is indicated, specifically asking the patient whether there are temporary
flares of pain that are more intense than the constant pain.
4. Quality of pain. This information is helpful in diagnosing the underlying pain
mechanism. Soreness is commonly more likely to be indicative of somatic pain, whereas
burning or knifelike pain is more likely to be indicative of neuropathic pain. This
information may have direct implications for the type of pain treatment chosen. For
example, an anticonvulsant (an adjuvant analgesic) may be indicated for knifelike pain.
One study found that the quality of pain seemed to cluster in three groups: (1) paroxysmal
pain sensations, such as shooting, sharp, and radiating pains; (2) superficial pain, such as
itchy, cold, sensitive, and tingling pains; and (3) deep pain, such as aching, dull, cramping,
and throbbing pain (Victor, Jensen, Gammaitoni, et al., 2008).
If the patient has difficulty describing pain, the clinician should ask the patient about
the appropriateness of possible descriptors, such as throbbing, shooting, sharp,
cramping, aching, tender, pricking, burning, or pulling. For the patient who continues to
have difficulty, try asking him or her, “What could you do to me to make me feel the pain
you have?”
5. Onset, duration, variations, rhythms. To detect variations and rhythms, ask the patient,
“When did this pain begin?” “Is the pain better or worse at certain times, certain hours of
the day or night, or certain times of the month?”
6. Manner of expressing pain. Ask the patient if he or she is hesitant or embarrassed to
discuss the pain or whether the patient tries to hide it from others. Ask the patient if using
the pain rating scale is acceptable.
7. What relieves the pain? If the patient has had pain for a while, he or she may know
which medications and doses are helpful and may have found some nondrug methods,
such as cold packs, helpful. If appropriate, these methods should be continued.
8. What causes or increases the pain? A variety of activities, body positions, and other
events may increase pain, and efforts can be made to avoid them or to provide additional
analgesia at those times.
9. Effects of pain. These items help to identify how pain affects the patient’s quality of life
and how pain interferes with recovery from illness. Information obtained in this section
may be useful in developing pain management goals. If pain interferes with sleep, a major
goal may be to identify a pain rating that will allow the patient to sleep through the night
without being awakened by pain.
10. Other comments. No tool is comprehensive. This space simply allows for information
the patient may wish to add.

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11. Plan. Immediate and long-range plans can be mentioned here and developed in
greater detail as time passes.

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Related Vocabularies

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Variety of Pain
 Aching /ˈākiNG/ (adj) : sakit yang intens
 Burning /ˈbərniNG/ (adj) : sakit seperti terbakar
 Cramping /krempiNG/ (adj) : kram
 Pricking /prikiNG/ (adj) : sakit seperti tertusuk
 Pulling /po͝ oling/ (adj) : sakit seperti ditarik
 Radiating (adj) : sakit yang menjalar
 Shooting /ˈSHo͞odiNG/ (adj) : rasa sakit seperti ditembak
 Stabbing /stabiNG/ (adj) : sakit seperti ditikam
 Throbbing /ˈTHräbiNG/ (adj) : sakit berdenyut-denyut
 Tingling (adj) : nyeri kesemutan
 Cold /kōld/ (adj) : kedinginan
 Dull /dəl/ (adj) : sakit yang membosankan
 Itchy /ˈiCHē/ (adj) : gatal
 Knifelike /nīf līk/ (adj) : seperti pisau
 Sensitive /ˈsensədiv/ (adj) : sensitive
 Sharp /SHärp/ (adj) : tajam
 Tender /ˈtendər/ (adj) : rasa sakit yang lembut

Useful Expressions
Direction. Study the following useful expressions. These expressions can be used in the interview to fill
a pain assessment form.
1 Location
 Where do you feel the pain?
 Show me the location of your pain.

2 Intensity
 From 0 to 10, with 10 being the worst, how would you rate what you feel
right now?

3 Pain consistency
 Is this pain constant?
 If not, how often does it occur?

4 Quality of pain
 What is the pain like?
 Is it dull, sharp, stabbing, or aching?
 What could you do to me to make me feel the pain you have?

5 Onset, duration, variations, rhythms

 When did this pain begin?
 When did you first notice it?
 Is the pain better or worse at certain times, certain hours of the day or night,
or certain times of the month?

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 6 Manner of expressing pain
 Are you embarrassed to discuss your pain?
 Did you try to hide your pain from others?

7 Alleviating factors
 What relieves your pain?
 What makes your pain better?

8 Aggravating factors
 What causes or increases the pain?
 What makes your pain worse?

9 Effects of pain
 How did the pain affect your life?
 How did the pain interfere with your recovery from this illness?

10 Other comments
 Do you wish something?

Integrated Writing and Speaking Exercise

Direction. Arrange the jumbled words in each number to be a structured expression.
1. Where – the – feel - you – do – pain?
Where do you feel the pain?
2. From – worst – from – 10 – to – 0 – being – with – the – 10 – rate – would – you –
how – right – what – feel – you – now?
From 0 to 10, whith 10 being the the worts, how would you rate what you feel right
now?
3. What – pain – is – the – like?
What ia the pain like?
4. What – pain – your – makes – better?
What makes your paint better?
5. How – affect – pain – did – your – pain – the – life?
How did teh pain effect your life?

Integrated Listening and Speaking Exercise

Direction. Accomplish the following conversation by listening to the audio file on UFLearn. Then, act out
the dialogue.

Case: a patient is suspected of having ovarian cysts. A nurse notices a swelling in the
lower abdomen.

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Nurse : Mrs. Scott, I need to fill in a medical report about your health status.
Patient : Sure.
Nurse : Do you feel any pain (1) in your abdomen?
Patient : Yes I feel a little bit pain. I also feel pain (2) when having a sexual
intercourse I feel nausea and fever.
Nurse : (3) Where is the pain? Could you point at the pain?
Patient : It’s around here.
Nurse : Well, thank you Mrs. Scott for your information. I will report this to your
obstetrician.
(The conversations were taken from English for Professional Nurses 1 written by Leo A.
Pamudya.)

Nursing Communication Practice

Direction. Work in pair. Write an interview of a nurse to a patient to fill the pain assessment form above.
Submit your conversation scenario on UFLearn. Then, practice the conversation together. You are not
allowed to read aloud the scenario.

Nurse : good afternoon ma'am

Patient : afternoon nurse
Nurse : ma'am Here I want to interview you to find out your current condition, about 5-10
minutes, are you available, is there anything you would like to develop?
Patient: there is not any

Nurse : how are you now ma'am?

Patient: okay
Nurse : what is your complaint at this time?
Patient: pain in the abdomen
Nurse: when did you feel severe pain or not?

Patient: during activity the pain is very intense but at rest the pain subsides
Nurse : Where is the pain in the area ma'am, does the pain radiate?
Patient: no problem, only in the left abdominal area
Nurse: I'll give you a pain scale of 1-10. On what scale do you think the pain is?
Patient : 5

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 Nurse: for the pain to persist or to come and go?
Patient: missing
Nurse : Are there any other complaints besides pain?

Patient : no
Nurse : Does this pain interfere with you activities?
Patient: yes
Nurse: Do you have a history of other illnesses?
Patient: no

Nurse: how do you feel when you are sick like this?
Patient: my activities are disturbed
Nurse : has there been any change during the illness?
Patient: Yes, it's hard to sleep
Nurse: ok ma'am later I will tell the doctor about ma'am's condition

Patient : ok nurse thank you

Nurse : ok ma'am, this interview has been completed, thank you for taking the time I will
say goodbye, do you want to ask ma'am?
Patient : no
Nurse: ok ma'am, I'm sorry, if you need something you can press the button on the side,
ma'am, thank you wassalamualaikum wr, wb
Patient : waalaikumsalam