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    Pain Assessment Form

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    Pipit
    The patient is experiencing occasional pain in their stomach caused by consuming too much alcohol, smoking, and eating spicy or sour foods over a long period of time. The pain feels uncomfortable and is accompanied by symptoms like vomiting, vomiting blood, stomach aches, nausea, and bowel movements. The patient takes aspirin and antacids to relieve the pain, but it is still quite severe at times. A physical examination and endoscopy are recommended to further evaluate the stomach issues and help the patient better manage their diet and lifestyle.

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    Pain Assessment Form

    Uploaded by

    Pipit
    165 views1 page
    The patient is experiencing occasional pain in their stomach caused by consuming too much alcohol, smoking, and eating spicy or sour foods over a long period of time. The pain feels uncomfortable and is accompanied by symptoms like vomiting, vomiting blood, stomach aches, nausea, and bowel movements. The patient takes aspirin and antacids to relieve the pain, but it is still quite severe at times. A physical examination and endoscopy are recommended to further evaluate the stomach issues and help the patient better manage their diet and lifestyle.

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    PAIN ASSESSMENT FORM

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    The patient is experiencing occasional pain in their stomach caused by consuming too much alcohol, smoking, and eating spicy or sour foods over a long period of time. The pain feels uncomfortable and is accompanied by symptoms like vomiting, vomiting blood, stomach aches, nausea, and bowel movements. The patient takes aspirin and antacids to relieve the pain, but it is still quite severe at times. A physical examination and endoscopy are recommended to further evaluate the stomach issues and help the patient better manage their diet and lifestyle.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    165 views1 page

    Pain Assessment Form

    Uploaded by

    Pipit
    The patient is experiencing occasional pain in their stomach caused by consuming too much alcohol, smoking, and eating spicy or sour foods over a long period of time. The pain feels uncomfortable and is accompanied by symptoms like vomiting, vomiting blood, stomach aches, nausea, and bowel movements. The patient takes aspirin and antacids to relieve the pain, but it is still quite severe at times. A physical examination and endoscopy are recommended to further evaluate the stomach issues and help the patient better manage their diet and lifestyle.

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    A.

    CURRENT PAIN MEDICATION (Include dosage and any side effects)


    Take aspirin when the pain recurs and the use of antacids (mylanta) to relieve symptoms of vomiting, vomiting
    of blood, abdominal pain, nausea, bowel movements and overcome irritation due to gastric erosion

    B. WHERE IS PATIENT’S PAIN? C. DESCRIBE CAUSE OF PAIN, IF KNOWN


    Have patient point to or trace area of pain. Consuming too much alcohol, smoking, sometimes eating too
    If more than one site, label A, B, C, or D much especially spicy and sour food, and taking aspirin for a
    long time

    D. HOW DOES PAIN FEEL TO PATIENT?


    Feeling uncomfortable, vomiting, vomiting of blood, stabbing
    stomachache, nausea, and bowel movements
    E. INTENSITY OF PAIN (Rate on Scale of 0-5)
    INTENSITY
    SITE A SITE SITE SITE
    B C D
    1.AT PRESENT 2
    2.ONE HOUR
    AFTER
    MEDICATION
    3.THREE AFTER
    MEDICATION
    4.WORST IT GETS
    5.BEST IT GETS

    F. FREQUENCY OF PAIN (Check one for each site)


    FREQUENCY
    SITE A SITE B SITE C SITE D
    1. OCCASIONAL √
    2. FREQUENT
    3. CONSTANT
    G. PATIENT’S VIEW OF PAIN
    1. WHAT MAKES PAIN BETTER? By taking antacid (mylanta)
    2. WHAT MAKES PAIN WORSE? Irritation in the stomach because most consume alcohol, smoke, spicy and
    sour food
    3. ANY ASSOCIATED SYMPTOMS? Vomiting, vomiting of blood, stomach ache, nausea, bowel movements
    4. ARE THERE TIMES OF THE DAY/NIGHT WHEN PAIN IS WORSE? -
    5. WHAT HAS HELPED CONTROL PAIN IN THE PAST? Taking aspirin for pain relief
    6. WHAT IS PAI PREVENTING PATIENT FROM DOING? Take aspirin, avoid alcoholic beverages, not smoke,
    reduce spicy food and acid
    7. DOES PATIENT WANT SOMETHING DONE ABOUT PAIN? (If no, why not?) Yes, because the symptoms
    that arise are quite severe so it is not enough if only given antacid drugs (mylanta), must do a physical
    examination and supporting examinations such as endoscopy
    8. COMMENTS: It is recommended to better maintain diet, avoid alcoholic beverages, smoking, reduce eating
    spicy and sour foods

    DATE May 13 2020 SIGNATURE OF ASSESSOR Niyan Ayu Saputri, S.Kep

    Imprint Patient Identificationor Write-in Information Below


    PAIN ASSESSMENT Patient’s Name Mr. Jonas Johnson
    Medical Record No. 01 01 11

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