Nursing Care Plans Acute Pain Nursing Diagnosis & Care Plan: Assessment, Interventions, and SMART Goals
Writing a care plan for acute pain can feel overwhelming when every clinical instructor seems to want it formatted differently and the NANDA-I phrasing trips you up. Let’s make this simple.
This guide walks through the acute pain nursing diagnosis the way it actually shows up on care plans and NCLEX-RN® questions — assessment, interventions with rationales, SMART goals, and five worked sample care plans you can adapt. By the end you’ll know exactly how to format an acute pain diagnosis, what to assess for, and which interventions are highest-yield.
In this guide
- What is acute pain?
- Causes (Related to)
- Signs and symptoms (As evidenced by)
- Sample nursing diagnoses
- Goals and outcomes (SMART format)
- Nursing assessment with rationales
- Nursing interventions for acute pain (with rationales)
- Sample care plans — 5 scenarios
- Escalation red flags (high-yield)
- Discharge and patient teaching
- Frequently asked questions
- Related care plans
- References
What is acute pain?
The International Association for the Study of Pain (IASP) defines pain as an unpleasant sensory and emotional experience associated with — or resembling that associated with — actual or potential tissue damage.¹ Margo McCaffery’s classic nursing principle still applies: pain is whatever the experiencing person says it is, existing whenever they say it does.²
Acute pain is a NANDA-I nursing diagnosis: a sudden or slow onset of an unpleasant sensory and emotional experience associated with actual or potential tissue damage, with an anticipated or predictable end and a duration of less than three months.³
Student note: NANDA-I defines acute pain as lasting less than 3 months. Some opioid-prescribing guidelines use a narrower definition — acute pain less than 1 month, subacute pain 1–3 months, chronic pain more than 3 months. For nursing care plans, follow the NANDA-I wording your program requires.
Think of acute pain as your body’s smoke alarm: short, loud, and pointing at the source. The pathophysiology starts with nociceptors — A-delta fibers carry the sharp, well-localized first pain; C fibers carry the dull, throbbing second pain that lingers. Those signals travel up the spinothalamic tract to the brain, where they’re interpreted and translated into the patient experience you’ll assess at the bedside.
Acute pain vs other pain types
| Type | Duration | Common causes | Key feature |
|---|---|---|---|
| Acute | < 3 months | Surgery, trauma, labor, MI, fracture | Predictable end; serves as a warning |
| Chronic | ≥ 3 months | Arthritis, cancer, fibromyalgia | Persists past expected healing |
| Neuropathic | Variable | Nerve injury, diabetic neuropathy, post-herpetic | Burning, shooting, tingling |
| Nociceptive | Variable | Tissue/bone injury | Throbbing, aching, sharp |
| Radicular | Variable | Nerve root compression (e.g., sciatica) | A neuropathic pattern that radiates along a nerve distribution. |
High-yield flag for NCLEX: if the question says less than 3 months or describes a clear inciting event with a predictable end, the answer is acute, not chronic.
Important: these categories overlap. Acute and chronic describe duration; nociceptive, neuropathic, and radicular describe mechanism. A patient can have acute nociceptive pain from a fracture, chronic neuropathic pain from diabetic neuropathy, or acute-on-chronic radicular pain from a herniated disc.
Causes (Related to)
NANDA-I groups the etiology of acute pain into three injury-agent categories. On your care plan, the phrase after “Related to” should name the specific agent for your patient, not the category.³
- Biological injury agents — infection (cellulitis, appendicitis), ischemia (MI, sickle-cell crisis), inflammation (pancreatitis, diverticulitis), tumor pressure
- Chemical injury agents — caustic exposure, chemotherapy-induced mucositis, irritants, certain medications
- Physical injury agents — surgical incision, fracture, burn, sprain, procedural pain (IV insertion, dressing change), labor, blunt trauma
Common clinical scenarios you’ll see again and again: postoperative pain, fracture pain, labor pain, MI/chest pain, and abdominal pain from inflammatory conditions like diverticulitis or appendicitis.
Signs and symptoms (As evidenced by)
A NANDA-I diagnostic statement uses subjective and objective data to defend why the diagnosis applies to this patient. Both matter — instructors often dock points when students list only one.³
Subjective data — what the patient says
- Pain rating on a 0–10 numeric scale (or age-appropriate alternative)
- Quality descriptors: sharp, dull, burning, throbbing, stabbing, cramping, aching
- Location and radiation pattern
- Onset, duration, and pattern (constant vs intermittent)
- Aggravating factors (movement, eating, breathing) and alleviating factors (position, medication, rest)
- Impact on sleep, appetite, and activities of daily living
Objective data — what you observe
- Vital sign changes: elevated heart rate, elevated blood pressure, increased respiratory rate
- Diaphoresis, pallor
- Guarding, splinting, or rigid posture
- Facial grimacing, furrowed brow, clenched teeth
- Restlessness or, in some patients, unusual stillness/withdrawal
- Crying or moaning
- Decreased participation in care
- FLACC score ≥ 4 (in non-verbal patients) or PAINAD score ≥ 1 (in advanced dementia)
For exams, focus on this: for cognitively intact patients, self-report is the primary pain assessment. In non-verbal patients, advanced dementia, heavy sedation, language barriers, or stoicism, behavioral cues and validated tools such as FLACC or PAINAD help detect pain the patient cannot or will not verbalize. Inability to communicate does not negate the possibility of pain.
Sample nursing diagnoses
Use this format on your care plan:
Acute pain related to [specific cause] as evidenced by [subjective + objective findings].
Four worked examples that match the most common student-assigned scenarios:
- Post-operative: Acute pain related to surgical incision (laparoscopic appendectomy) as evidenced by patient-reported pain rating of 8/10 on numeric scale, guarding of the abdomen, heart rate of 112, and grimacing on movement.
- Diverticulitis: Acute pain related to inflammation of intestinal diverticula as evidenced by left-lower-quadrant tenderness on palpation, self-report of 7/10 cramping pain, and elevated temperature of 38.4 °C.
- Labor: Acute pain related to uterine contractions during the active phase of labor as evidenced by patient-report of 9/10 cramping pain, increased respiratory rate, and clenched fists during contractions.
- Myocardial ischemia: Acute pain related to decreased coronary blood flow as evidenced by substernal chest pain rated 8/10, diaphoresis, nausea, and ST-segment depression on 12-lead ECG.
Goals and outcomes (SMART format)
Strong nursing goals are Specific, Measurable, Attainable, Realistic, and Time-bound. Pain goals that just say “patient will be pain-free” won’t survive your clinical instructor’s red pen. Use a number, a scale, and a timeframe.
Short-term goals (within 1–2 hours or end of shift)
- Patient will report pain of ≤ 3/10 on the numeric rating scale within 60 minutes of analgesic administration.
- Patient will demonstrate one non-pharmacologic relaxation technique (e.g., guided imagery, paced breathing) by the end of the shift.
- Patient will maintain a respiratory rate ≥ 12 breaths/min and SpO₂ ≥ 94% following opioid administration.
Long-term goals (within 24–72 hours or by discharge)
- Patient will maintain pain control at ≤ 3/10 on the prescribed analgesic regimen and resume baseline activities of daily living prior to discharge.
- Patient will verbalize an understanding of the prescribed pain regimen, including dose, frequency, and red-flag side effects, prior to discharge.
- Patient will demonstrate effective use of both pharmacologic and non-pharmacologic strategies by the second post-operative day.
Function-based goals
Pain goals should include both intensity and function. A realistic acute-pain goal is not always “0/10.” It may be:
- Pain ≤ 3/10 while coughing and deep breathing
- Pain controlled enough to ambulate 50 feet
- Pain controlled enough to sleep for 3 uninterrupted hours
- Pain controlled enough to participate in physical therapy
Functional goals help you and the team evaluate whether pain control is actually supporting recovery — not just whether the number dropped.
High-yield flag: the NCLEX-RN favors goals that are patient-centered (start with “Patient will…”) and measurable (uses a number or scale). If a goal can’t be evaluated as “met” or “not met,” rewrite it.
Nursing assessment with rationales
The PQRSTU framework
Use PQRSTU as your assessment script — it’s faster than free-form and harder to forget under pressure.
- P — Provocation/palliation: what makes it worse, what makes it better
- Q — Quality: how does it feel (sharp, dull, burning, throbbing)
- R — Region and radiation: where it is, where it travels
- S — Severity: 0–10 rating (or age-appropriate scale)
- T — Timing: onset, duration, pattern
- U — Understanding / U-experience: what the patient thinks is causing it; any previous experience with this pain
Pain scale comparison
Pick the scale based on patient ability, not preference. The wrong scale leads to underdosed pain.
| Scale | Best for | How to use | Concern threshold |
|---|---|---|---|
| Numeric Rating Scale (NRS) | Cognitively intact adults and adolescents | “On a scale of 0–10, with 0 being no pain and 10 being the worst pain imaginable…” | ≥ 4 prompts intervention |
| Wong-Baker FACES | Children ≥ 3 years; adults with literacy or language barriers | Patient points to the face that matches | ≥ 4 (third face) |
| FLACC | Children 2 months–7 years; non-verbal patients | Score 0–2 each on Face, Legs, Activity, Cry, Consolability (total 0–10) | ≥ 4 |
| PAINAD | Patients with advanced dementia | Score 0–2 each on Breathing, Negative Vocalization, Facial Expression, Body Language, Consolability (total 0–10) | ≥ 1 indicates possible discomfort and should trigger further assessment |
| CRIES | Neonates | Crying, Requires O₂, Increased VS, Expression, Sleeplessness (each 0–2) | ≥ 4 |
Assessment items with rationales
| Assess | Why we do it | What to document |
|---|---|---|
| Vital signs | Sympathetic response to pain raises HR, BP, and RR | Baseline + reassessments q2h or per protocol |
| Pain rating | Establishes severity and response to treatment | Score, scale used, time |
| PQRSTU details | Differentiates pain types and points toward etiology | Each letter with patient’s own words |
| Behavioral cues | Catches pain in stoic, non-verbal, or cognitively impaired patients | Grimacing, guarding, restlessness, FLACC/PAINAD score |
| Functional limitation | Acute pain that blocks ambulation, coughing, or deep breathing increases complications | Specific tasks the patient avoids |
| Cultural and spiritual context | Pain expression varies; influences both report and acceptance of interventions | Patient preferences, religious considerations |
| Prior analgesic response | Predicts what will and won’t work | Effective regimens, allergies, opioid history |
| Re-assessment after intervention | Confirms whether the intervention worked | Pain rating 30–60 min after IV/PO analgesic; timing per institutional policy |
Population callouts
- Pediatric: use age-appropriate scales (FLACC under 7, Wong-Baker 3+, NRS school-age and older); involve caregivers in interpretation.
- Geriatric: older adults under-report pain and are at higher risk for medication side effects; check renal/hepatic function before NSAIDs and opioids; review the AGS Beers Criteria for high-risk medications.
- Cognitive impairment: lean on PAINAD and behavioral observation; pain is frequently missed in this population.
Nursing interventions for acute pain (with rationales)
Non-pharmacologic interventions
| Intervention | Rationale |
|---|---|
| Reposition every 2 hours and align in anatomic position | Reduces pressure on bony prominences and relieves musculoskeletal strain |
| Apply cold therapy for acute injury or inflammation | Vasoconstriction reduces edema and slows nociceptor transmission |
| Apply heat for muscle spasm or chronic-on-acute pain | Vasodilation relaxes muscle and improves perfusion |
| Distraction (music, television, guided imagery) | Engages competing cortical pathways and reduces perceived pain intensity |
| Paced breathing and progressive muscle relaxation | Down-regulates sympathetic response and lowers HR and BP |
| Massage and cutaneous stimulation | Activates gate-control mechanism per Melzack and Wall¹⁰ |
| TENS (transcutaneous electrical nerve stimulation) | Stimulates large-fiber input that inhibits pain transmission at the spinal cord |
| Splinting during cough or movement after thoracic/abdominal surgery | Reduces tension on the incision and supports deep-breathing exercises |
| Environmental modification (low lights, low noise, clustered care) | Lowers stimulus load that amplifies pain perception |
Pharmacologic interventions
Acute pain management is usually multimodal: combine non-pharmacologic strategies, non-opioid medications, and opioid analgesics when clinically indicated.⁷ The goal is not always “zero pain” — the goal is a tolerable pain level that allows safe breathing, movement, sleep, healing, and participation in care.
The CDC notes that non-opioid therapies are at least as effective as opioids for many common acute-pain conditions, while opioids still have a role for severe traumatic injuries, invasive surgeries, and severe acute pain when alternatives are ineffective or contraindicated.⁹
| Intervention | Rationale | Watch for |
|---|---|---|
| Administer non-opioids first when appropriate — acetaminophen, NSAIDs (ibuprofen, ketorolac) | First-line for mild–moderate pain; minimizes opioid load | Hepatotoxicity (acetaminophen > 4 g/24 h); GI bleed, renal injury (NSAIDs). See acetaminophen nursing considerations and aspirin nursing considerations. |
| Administer opioids as ordered — morphine, hydromorphone, fentanyl | Strong analgesia for moderate–severe acute pain | Respiratory depression, sedation, constipation, urinary retention; have naloxone available |
| Use multimodal analgesia (combine drug classes) | Lower opioid doses with equal or better pain control | Drug interactions, additive sedation |
| Administer adjuvants — gabapentin, low-dose ketamine, antidepressants (for neuropathic component) | Targets pain pathways NSAIDs and opioids miss | Sedation, dizziness; monitor renal function |
| Patient-controlled analgesia (PCA) when ordered | Patient-initiated dosing improves pain control and lowers total opioid use | Educate the patient — only the patient may push the button; never PCA-by-proxy |
| Pre-medicate before painful procedures (dressing change, ambulation, physical therapy) | Prevents pain peaks that are harder to control retroactively | Time onset of analgesic to procedure (e.g., IV morphine peaks in 15–30 minutes) |
| Avoid intramuscular analgesic routes when alternatives exist | IM injections are painful, have variable absorption, and are not first-line per current evidence⁷ | Use PO, IV, regional, neuraxial, or PCA routes as appropriate to the patient’s condition and orders |
Opioid safety: before, after, and red flags
| Nursing check | What to assess |
|---|---|
| Before opioid administration | Pain score, sedation level, respiratory rate, SpO₂, blood pressure, allergies, last dose/time, opioid tolerance, renal/hepatic risk, and concurrent CNS depressants |
| After opioid administration | Pain relief, sedation, respiratory quality, RR/SpO₂, BP, nausea, pruritus, urinary retention, and constipation risk |
| Hold and notify provider per policy | Difficult to arouse, rising sedation, respiratory depression, hypotension, new confusion, oxygen desaturation, or suspected oversedation |
Sedating-combination caution: opioids combined with benzodiazepines, alcohol, gabapentin, pregabalin, muscle relaxants, or other sedating medications multiply the risk of severe sedation and respiratory depression. The AGS 2023 Beers Criteria specifically flags opioid + benzodiazepine and opioid + gabapentinoid combinations as higher-risk in older adults.¹¹
Monitor for
- Respiratory depression (RR < 12, decreased SpO₂, increased sedation on the Pasero Opioid-Induced Sedation Scale) — the most dangerous opioid side effect⁵
- Sedation level — escalating sedation precedes respiratory depression
- Constipation — start a bowel regimen on day one of scheduled opioids
- Pruritus, nausea, urinary retention
- Pain control adequacy — re-rate pain 30–60 minutes post-dose (per route)
- Inadequate analgesia, escalating dose needs, tolerance, physical dependence or withdrawal risk with prolonged opioid use, and signs of opioid misuse or opioid use disorder⁹
- Drug interactions — opioids + benzodiazepines + alcohol multiply respiratory risk
Duration caution: opioid quantities should be limited to the expected duration of severe acute pain. Patients taking around-the-clock opioids for more than a few days may need a taper rather than abrupt discontinuation.⁹
Sample care plans (5 scenarios)
Scenario 1 — Post-operative abdominal surgery
Diagnostic statement: Acute pain related to surgical incision as evidenced by self-report of 8/10 pain, abdominal guarding, and HR 112.
Short-term goal: Patient will report pain ≤ 3/10 within 60 minutes of analgesic administration and use the incentive spirometer 10 times per hour while awake.
Assessment: Pain rating q1h until controlled, then q4h; sedation and respiratory status before and after opioid administration; incision site for bleeding or dehiscence; bowel sounds; respiratory effort. or dehiscence; bowel sounds; respiratory effort.
Interventions: Administer scheduled non-opioid analgesics (e.g., IV/PO acetaminophen) and PCA opioid as ordered; reposition q2h; teach splinted coughing; pre-medicate before ambulation; encourage early mobility once safe — uncontrolled pain increases the risk of atelectasis, pneumonia, venous thromboembolism, and delayed recovery.⁶
Evaluation: Pain at goal, patient ambulating, lungs clear, no signs of ileus.
Scenario 2 — Acute pain related to fracture
Diagnostic statement: Acute pain related to closed right femur fracture as evidenced by self-report of 9/10 pain, inability to bear weight, and deformity of the right thigh.
Short-term goal: Patient will report pain ≤ 4/10 within 60 minutes of analgesic administration and maintain proper alignment of the affected limb.
Assessment: Neurovascular checks (pulses, color, temperature, capillary refill, motor, sensation) distal to the fracture q1h initially; pain rating; signs of compartment syndrome
Compartment-syndrome monitoring (high-yield): early warning signs are pain out of proportion to injury and pain with passive stretch, plus tense swelling and paresthesia. Pulselessness, pallor, poikilothermia, and paralysis are late signs — escalate immediately when early signs appear; do not wait for late findings.⁶
Interventions: Immobilize per protocol; ice; elevate when ordered; administer IV opioid + scheduled acetaminophen; reposition with proper support; pre-medicate before reduction or transfer.
Evaluation: Pain at goal, neurovascular status intact, no signs of compartment syndrome.
Scenario 3 — Acute pain related to labor
Diagnostic statement: Acute pain related to uterine contractions during the active phase of labor as evidenced by self-report of 9/10 cramping pain, increased respiratory rate, and clenched fists during contractions.
Note: some programs use the NANDA-I diagnosis Labor Pain (00256) for childbirth rather than Acute Pain. Follow your instructor’s required diagnostic label.³
Short-term goal: Patient will report a pain level she can manage with her chosen method (epidural, IV opioid, or non-pharmacologic) within 30 minutes of intervention.
Assessment: Contraction pattern (frequency, duration, intensity); fetal heart rate; pain coping behavior; maternal vital signs; bladder distension.
Interventions: Position changes (peanut ball, side-lying); paced breathing coaching; hydrotherapy if available; offer pharmacologic options per provider — IV opioid (e.g., nalbuphine, fentanyl) or epidural; continuous fetal monitoring per protocol.
Evaluation: Patient coping effectively; fetal heart rate reassuring; labor progressing.
Scenario 4 — Acute pain related to myocardial ischemia
Diagnostic statement: Acute pain related to decreased coronary blood flow as evidenced by substernal chest pain rated 8/10, diaphoresis, and ST-segment depression on 12-lead ECG.
Short-term goal: Patient will report pain ≤ 2/10 within 30 minutes of intervention and maintain HR 60–100 bpm and SpO₂ ≥ 94%.
Assessment: Continuous cardiac monitoring; serial 12-lead ECGs; troponin trend; vital signs q5–15 min during active pain; bleeding precautions if on anticoagulants.
Interventions: Remember MONA-B for stable suspected ACS (Morphine, Oxygen if SpO₂ < 90%, Nitroglycerin, Aspirin, Beta-blocker) — administer per orders and protocol; obtain IV access; prepare for cath lab if STEMI; reassure the patient.
Evaluation: Pain controlled, hemodynamics stable, no progression of ischemia.
See: Myocardial Infarction Nursing Care Plan · Chest Pain Nursing Care Plan
Scenario 5 — Acute pain related to diverticulitis
Diagnostic statement: Acute pain related to inflammation of intestinal diverticula as evidenced by left-lower-quadrant tenderness on palpation, self-report of 7/10 cramping pain, and temperature of 38.4 °C.
Short-term goal: Patient will report pain ≤ 3/10 within 60 minutes of analgesic administration and tolerate clear liquids without an increase in pain.
Assessment: Abdominal exam (tenderness, distension, rebound, bowel sounds); temperature; WBC trend; pain rating; intake/output; bowel pattern.
Interventions: NPO or clear liquid diet per orders; IV fluids; IV antibiotics; IV opioid for severe pain plus scheduled acetaminophen (avoid NSAIDs if GI bleed is suspected); heat to abdomen if not contraindicated.
Evaluation: Pain controlled, afebrile, abdominal exam improving, no signs of peritonitis.
See: Diverticulitis Nursing Care Plan
Escalation red flags (high-yield)
| Situation | Escalate for |
|---|---|
| Any opioid use | Difficult to arouse, respiratory depression, oxygen desaturation, hypotension, new confusion |
| Post-op pain | Sudden severe pain, bleeding, wound dehiscence, rigid abdomen, hypoxia |
| Fracture | Pain out of proportion, pain with passive stretch, tense compartment, numbness/tingling, worsening neurovascular status |
| Chest pain / ACS | Persistent or worsening chest pain, dysrhythmia, hypotension, ECG changes, rising troponin |
| Abdominal pain / diverticulitis | Rebound tenderness, guarding/rigidity, fever, tachycardia, hypotension, vomiting, signs of sepsis |
Discharge and patient teaching
| Teaching point | What the nurse should explain |
|---|---|
| Take pain medicine before pain becomes severe | Severe pain is harder to control once it peaks |
| Use non-pharmacologic strategies | Positioning, ice/heat if appropriate, relaxation, splinting, and distraction can reduce medication needs |
| Track total acetaminophen | Many combination medications contain acetaminophen — adding more from another product can cause toxicity |
| Avoid dangerous combinations | Do not mix opioids with alcohol, benzodiazepines, sleep medications, gabapentin, or other sedatives unless specifically prescribed¹¹ |
| Prevent constipation | Fluids, mobility, fiber, stool softeners, and a bowel regimen as ordered |
| Fall precautions | Opioids, gabapentin, muscle relaxants, and sedatives can cause dizziness or sedation |
| Safe opioid storage and disposal | Store securely and dispose of unused doses according to local guidance |
| Know red flags | Slow breathing, excessive sedation, chest pain, new weakness/numbness, rigid abdomen, fever, or uncontrolled pain |
Frequently asked questions
Is acute pain a nursing diagnosis?
Yes. Acute pain is a long-standing NANDA-I nursing diagnosis under the Comfort domain, defined as a sudden or slow-onset unpleasant sensory and emotional experience tied to tissue damage, with a duration of less than three months.³
Why is acute pain a priority nursing diagnosis?
Acute pain is usually a priority because it interferes with breathing, mobility, sleep, and healing — and because it can be the warning sign of a serious problem (think MI, compartment syndrome, peritonitis). Using Maslow’s hierarchy, pain falls within physiological needs; using ABCs, it can compromise breathing and circulation. Both frameworks push it high on the priority list.
How long does acute pain last?
By NANDA-I definition, less than three months. Most acute-pain episodes resolve faster — postoperative pain typically peaks in 24–72 hours and then declines as healing progresses. Pain persisting past three months is reclassified as chronic pain.³
Note that opioid-prescribing guidelines define the windows more narrowly: acute < 1 month, subacute 1–3 months, chronic > 3 months.⁹
What’s the difference between acute pain and chronic pain on a care plan?
Two main differences: duration and goals. Acute pain has a clear cause and an anticipated end — your goals focus on relief and on preventing complications during healing. Chronic pain doesn’t resolve on a predictable timeline — your goals focus on function, coping, and quality of life rather than pain elimination. The diagnostic statement, assessment, and intervention list change accordingly.
How do you write SMART goals for acute pain?
Use a number, a scale, and a timeframe. Instead of “Patient will be pain-free,” write “Patient will report pain ≤ 3/10 on the numeric rating scale within 60 minutes of analgesic administration.” Both short-term (1–2 hours) and long-term (24–72 hours or by discharge) goals should be patient-centered, measurable, and time-bound.
Pair every intensity goal with a function goal — pain controlled enough to cough, ambulate, sleep, or participate in therapy.
Related care plans
- Chronic Pain Nursing Care Plan
- Chest Pain Nursing Care Plan
- Myocardial Infarction Nursing Care Plan
- Postpartum Nursing Care Plan
- Appendicitis Nursing Care Plan
- Diverticulitis Nursing Care Plan
- Preeclampsia Nursing Care Plan
Acute pain care plans look intimidating until you realize they always follow the same skeleton — definition, NANDA statement, assessment, intervention, evaluation. Lock the skeleton in once and every scenario becomes a fill-in-the-blank. You’ve got this.
Ready to test what you just learned? Try a few pain-management practice questions in NCLEX format and build confidence before test day.
References
- Raja SN, Carr DB, Cohen M, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976–1982.
- McCaffery M, Pasero C. Pain: Clinical Manual. 2nd ed. Mosby; 1999.
- Herdman TH, Kamitsuru S, Lopes CT, eds. NANDA International Nursing Diagnoses: Definitions and Classification, 2024–2026. 13th ed. Thieme; 2024.
- World Health Organization. WHO Guidelines for the Pharmacological and Radiotherapeutic Management of Cancer Pain in Adults and Adolescents. WHO; 2018.
- Pasero C, McCaffery M. Pain Assessment and Pharmacologic Management. Mosby; 2011.
- Lippincott Manual of Nursing Practice. 11th ed. Wolters Kluwer; 2023.
- Chou R, Gordon DB, de Leon-Casasola OA, et al. Management of postoperative pain: a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016;17(2):131–157.
- The Joint Commission. Pain Assessment and Management Standards for Hospitals (current standards page). TJC.
- Dowell D, Ragan KR, Jones CM, et al. CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. MMWR Recomm Rep. 2022;71(3):1–95.
- Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150(3699):971–979.
- By the 2023 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052–2081.
- Writing Committee, American College of Cardiology / American Heart Association. 2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes.
- Varndell, W., Fry, M., & Elliott, D. (2017). Exploring how nurses assess, monitor and manage acute pain for adult critically ill patients in the emergency department: protocol for a mixed methods study. Scandinavian journal of trauma, resuscitation and emergency medicine, 25(1), 75. https://doi.org/10.1186/s13049-017-0421-x https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540572/
