Assessment Diagnosis Planning Intervention Rationale Evaluation

Subjective: Acute pain related to Short term: Independent Short term:

“Sumasakit yung thoracentesis
tinusukan sa akin” as procedure. After 4 hours of Assess pain Assessment of pain After 4 hours of
verbalized by the nursing interventions, characteristics experience is the first nursing interventions,
patient. the patient will step in planning pain the patient verbalized
verbalize a decrease management a decrease of pain
Pain of 7/10. of pain from 7 to 4. strategies. The most from 7 to 4.
reliable source of
Objective: Long term: information about the Long term:
pain is the patient.
Appetite changes After 12 hours of Descriptive scales Goal was not met.
nursing interventions, such as a visual
Facial mask of pain the patient will analogue can be
verbalize pain control utilized to distinguish
at a level less than 3 the degree of pain.
on a rating scale of 0
– 10. One’s experiences of
Provide rest periods pain may become
to promote relief, exaggerated as a
sleep, and relaxation. result of exhaustion.
Pain may result in
fatigue, which may
result in exaggerated
pain. A peaceful and
quiet environment
may facilitate rest.

Patients may
experience an
Get rid of additional exaggeration in pain
stressors or sources or a decreased ability
of discomfort to tolerate painful
whenever possible. stimuli if
environmental,
intrapersonal, or
intrapsychic factors
are further stressing
them.