1. Assessment
   1. Subjective
      1. What to ask?
         1. Duration
         2. Location
         3. Intensity
            1. What scale to use?
            2. 10 Point Scale - Most commonly used
            3. Wong Baker Scale - For nonverbal or those who do not speak English - For individuals 3 or older
            4. Pain Assessment in Advanced Dementia (PAINAD)
            5. Non-verbal Pain Scale
         4. Quality
         5. Chronology
         6. Aggravating factors
         7. Alleviate Factors
         8. Effect on Activities of Daily Living (ADL) and Lifestyle
   2. Objective
      1. What you see?
         1. Responses
            1. Physiological
            2. Vital Signs
            3. Behavioral
            4. Affective
         2. Baseline prior to med administration
2. Diagnosing
   1. Acute Pain (specify location)
   2. Chronic Pain (specify location)
   3. Other diagnosis associated to pain
      1. Ineffective Airway Clearance r/t weak cough secondary to abdominal surgery
      2. Anxiety r/t past experiences of poor pain control
      3. Impaired physical mobility r/t pain secondary to arthritic pain in right knee
3. Planning
   1. Goal: Alleviate pain and promote highest level of function
   2. Goals is realistic or ideal?
   3. Combo of pharmacologic and non-pharmacologic
   4. Assessment, reassessment, and follow-up
   5. Who's involved? Remember patient centered.
   6. Consults with Pain Pharmacy and Palliative
4. Implementation
   1. WHO- Stepwise Approach to pain (Start low and go slow)
   2. Interventions
      1. Pharmacologic
         1. Opioid
         2. Non-opioid
         3. Adjuvant
      2. Non-pharmacologic
         1. Cutaneous stimulation
         2. Acupuncture/Healing Touch
         3. Distraction/Relaxation/Music
         4. Refer to you complementary and integrative Health lecture/chapter
5. Evaluation
   1. Outcome of pain management based on subjective and objective data
   2. Assess and document 30-60 minutes after administration of interventions
   3. Note any adverse effects