NURSING DIAGNOSIS: Pain, acute
May be related to
- Hyperperistalsis, prolonged diarrhea, skin/tissue irritation, perirectal excoriation, fissures, fistulas
Possibly evidenced by
- Reports of colicky/cramping abdominal pain/referred pain
- Guarding/distraction behaviors, restlessness
- Facial mask of pain; self-focusing
Desired Outcomes
Pain Level (NOC)
- Report pain is relieved/controlled.
- Appear relaxed and able to sleep/rest appropriately.
7 Inflammatory Bowel Disease Nursing Care Plan (NCP)
- Diarrhea — Inflammatory Bowel Disease Nursing Care Plan (NCP)
- Risk for Deficient Fluid Volume — Inflammatory Bowel Disease Nursing Care Plan (NCP)
- Anxiety — Inflammatory Bowel Disease Nursing Care Plan (NCP)
- Acute Pain — Inflammatory Bowel Disease Nursing Care Plan (NCP)
- Ineffective Coping — Inflammatory Bowel Disease Nursing Care Plan (NCP)
- Imbalanced Nutrition — Inflammatory Bowel Disease Nursing Care Plan (NCP)
- Knowledge Deficit — Inflammatory Bowel Disease Nursing Care Plan (NCP)
Acute Pain — Inflammatory Bowel Disease Nursing Care Plan (NCP): Nursing Interventions & Rationale
| Nursing Interventions | Rationale |
| Encourage patient to report pain. | May try to tolerate pain rather than request analgesics. |
| Assess reports of abdominal cramping or pain, noting location, duration, intensity (0–10 scale). Investigate and report changes in pain characteristics | Colicky intermittent pain occurs with Crohn’s disease |
| Note nonverbal cues, e.g., restlessness, reluctance to move, abdominal guarding, withdrawal, and depression. Investigate discrepancies between verbal and nonverbal cues. | Body language/nonverbal cues may be both physiological and psychological and may be used in conjunction with verbal cues to determine extent/severity of the problem. |
| Review factors that aggravate or alleviate pain. | May pinpoint precipitating or aggravating factors (such as stressful events, food intolerance) or identify developing complications. |
| Encourage patient to assume position of comfort, e.g., knees flexed. | Reduces abdominal tension and promotes sense of control. |
| Provide comfort measures (e.g., back rub, reposition) and diversional activities. | Promotes relaxation, refocuses attention, and may enhance coping abilities. |
| Cleanse rectal area with mild soap and water/wipes after each stool and provide skin care, e.g., A&D ointment, Sween ointment, karaya gel, Desitin, petroleum jelly. | Protects skin from bowel acids, preventing excoriation. |
| Provide sitz bath as appropriate. | Enhances cleanliness and comfort in the presence of perianal irritation/fissures. |
| Observe for ischiorectal and perianal fistulas. | Fistulas may develop from erosion and weakening of intestinal bowel wall. |
| Observe/record abdominal distension, increased temperature, decreased BP. | May indicate developing intestinal obstruction from inflammation, edema, and scarring. |
| Implement prescribed dietary modifications, e.g., commence with liquids and increase to solid foods as tolerated. | Complete bowel rest can reduce pain, cramping. |