A 73-year-old patient admitted after a stroke has expressive aphasia. Which pain intensity scales would be appropriate to use with this patient? Select all that apply
a. Visual analogue
b. Numerical rating
c. Wong-Baker face rating
d. Simple descriptor
e. PAINAD scale
A, B, C
The visual analogue requires patients to point to a location on a line that reflects their pain level. Some patients have difficulty with the abstract nature of this scale. The Wong-Baker face rating scale uses simple illustrations of faces to depict various levels of pain. The scale was developed for children but has proved effective for adults with communication and cognitive impairments. When using the numerical rating scale, the patient must choose a number from 0 to 10 to denote his pain level. This scale is sometimes difficult for clients with cognitive impairments, such as expressive aphasia; however, it would be appropriate to try it if the face-rating scale is not available. Patients commonly find the simple descriptor scale difficult to understand. This scale uses a list of adjectives that describe pain intensity. The Pain Assessment in Advanced Dementia (PAINAD) scale is a five-item, observational tool, specifically geared to older adults with dementia.
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