pain. There are a number of variations of this pain scale including the Face
Rating Scale and the Color Scale. The face rating scale uses expressions of car-
toon faces to assess pain while the color scale uses colors ranging from blue to
red where blue is freedom from pain and red is the most severe pain.
In addition to rating the intensity of the patient's pain, you also must assess
other characteristics of pain. These are onset, duration, frequency, what started
the pain (precipitating cause), and what relieves the pain.
Patients who are in chronic pain should keep a pain diary. A pain diary helps
the healthcare professional develop a pain management plan. The patient is asked
to keep a timed record of the pain experience to include when the pain starts,
what starts it, how bad it is, what relieves the pain, and any other factors that
may explain how the patient is responding to the pain. This record can help the
healthcare provider and the patient plan effective pain management.
The pain management plan contains both pharmacological and nonpharma-
cological strategies for managing the patient’s pain. Pharmacological strategies
involve using pain medication. Nonpharmacological strategies involve treat-
ments other than medication. These include massage, imagery, music, distraction,
humor, acupuncture, chiropractic interventions, hypnosis, herbal therapies, ther-
apeutic touch, and transcutaneous electronerve stimulation. Surgical interven-
tions are also sometimes performed to relieve pain.
Pharmacologic Management of Pain
Pharmacologic management of pain involves administering pain medication to
relieve the patient’s pain. These include non-narcotic analgesics, nonsterioidal
anti-inflammatory drugs (NSAIDs), narcotic analgesics, and salicylates.
Non-narcotic analgesics (see chart) are used to treat mild to moderate pain.
Many of these medications are not addictive and available over-the-counter.
Non-narcotic analgesics are used to treat headaches, menstrual pain (dysmenor-
rheal), pain from inflammation, minor abrasions, muscular aches and pain, and
mild-to-moderate arthritis. Non-narcotic analgesics also lower elevated body
temperature (antipyretic). Non-narcotic analgesics include acetaminophen and
NSAIDs (aspirin, ibuprofen, and COX-2 inhibitors), which were discussed in
Chapter 12.
See non-narcotic analgesics in the Appendix. Detailed tables show doses, rec-
ommendations, expectations, side effects, contraindications, and more; available
on the book’s Web site (see URL in Appendix).
CHAPTER 16 Narcotic Agonists^309