1. Vital Signs =Temperature =Pulse =Respiration =Blood Pressure =The fifth vital sign- observing and reporting the level of pain

2. Do not take an oral temperature on a person who….. Is unconscious Is using O 2 Is confused or disoriented Is paralyzed from stroke Has facial trauma Is likely to have a seizure Is younger than six years old Has sores, redness, swelling, or pain in her mouth Has an injury to the face or neck

3. Pain Management Pain is different for each person. What one person thinks is painful is not for another. Treat patients c/o pain seriously. Immediately report accurate. information to the nurse.

4. What to ask the client>>> Where is the pain When did the pain start? Is the pain mild, moderate, or severe Rate pain on scale of 1- 10 Ten the worst Ask the resident to describe the pain Ask what he or she was doing before the pain started.

6. Warm and Cold Applications Heat relieves pain and muscular tension Decreases swelling, elevates temperature in the tissues and increases blood flow. Increased blood flow brings more oxygen and nutrients to the tissues for healing.

7. Warm and Cold Application Cold can help stop bleeding. It prevents swelling and reduces pain. Cold helps bring down high fevers

8. Warm and Cold Applications Warm and dry applications may be dry or moist. Types of moist applications are: Compresses (warm or cold) Soaks (warm or cold) Tub baths (warm) Sitz bath (warm) Ice packs (cold) Types of dry applications are Aquamatic K-pad (warm or cold) Electric heating pad (warm) Disposable warm pack Ice bag Disposable cold pack

9. Warm and Cold Applications Report these to the nurse: Excessive redness Pain Blisters Numbness Hot opens (blood vessels) and cold closes (blood vessels) Only leave warm or cold applications on affected area for no longer than 20 minutes

10. Sitz Bath This is a warm soak of the perineal area. Sitz baths clean perineal wounds and reduces inflammation and pain Increases circulation. Sitz baths can be disposable that sits on a commode. Temperature of water is 100 0- 104 0 F The resident must be checked every five minutes and not left in water more than 20 minutes.

11. Warm and Cold Applications Moisture strengthens the effects of heat and cold. Observe area for redness, pain, or numbness