Form NDP20K "Acute Pain" - Alabama

What Is Form NDP20K?

This is a legal form that was released by the Alabama Department of Mental Health - a government authority operating within Alabama. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2018;
  • The latest edition provided by the Alabama Department of Mental Health;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form NDP20K by clicking the link below or browse more documents and templates provided by the Alabama Department of Mental Health.

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Download Form NDP20K "Acute Pain" - Alabama

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NDP 20k
July 2018
NAME __________________________________________________
Acute Pain
Date
Problem
Goal/Outcome
Interventions
Date
Evaluation
NOTES
Related To:
1. No complaint
(Address all items listed
NURSING
circled in “goal/
□Pain due to (state)
of pain > 3 on
1. Initial and ongoing
outcome” column. If
pain scale
pain assessment
goal not met, revise
2. Verbalizes
including VS
plan)
□Location (state)
effective pain
______ (freq)
relief/
2. Assess for probable
intervention
cause
AEB:
3. Evaluate response
□Last complaint of
to pain med
pain ________
4. Assess
(description)
ability/motivation to
Location
perform ADLs
Characteristic
5. Monitor weight
Onset
Duration
Frequency
Quality
Severity
Precipitating
DELEGATE
factors
1.Assist with meds as
Signs/
ordered/directed
symptoms
Take VS with each
0-10 scale
complaint of pain
□ guarding
2.Monitor for nonverbal
behavior
cues of pain (state)
□ moaning/crying
3. Inform MAS Nurse of
□ pacing
responsive pain med
□ facial mask of
4. Other (list)
pain
□ VS not WNL
□ sweating
□ nausea/vomiting
□ pale
RN SIGNATURE:
DATE:
Acute Pain
NDP 20k
July 2018
NAME __________________________________________________
Acute Pain
Date
Problem
Goal/Outcome
Interventions
Date
Evaluation
NOTES
Related To:
1. No complaint
(Address all items listed
NURSING
circled in “goal/
□Pain due to (state)
of pain > 3 on
1. Initial and ongoing
outcome” column. If
pain scale
pain assessment
goal not met, revise
2. Verbalizes
including VS
plan)
□Location (state)
effective pain
______ (freq)
relief/
2. Assess for probable
intervention
cause
AEB:
3. Evaluate response
□Last complaint of
to pain med
pain ________
4. Assess
(description)
ability/motivation to
Location
perform ADLs
Characteristic
5. Monitor weight
Onset
Duration
Frequency
Quality
Severity
Precipitating
DELEGATE
factors
1.Assist with meds as
Signs/
ordered/directed
symptoms
Take VS with each
0-10 scale
complaint of pain
□ guarding
2.Monitor for nonverbal
behavior
cues of pain (state)
□ moaning/crying
3. Inform MAS Nurse of
□ pacing
responsive pain med
□ facial mask of
4. Other (list)
pain
□ VS not WNL
□ sweating
□ nausea/vomiting
□ pale
RN SIGNATURE:
DATE:
Acute Pain
NDP 20k
July 2018
Acute Pain
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