一位有慢性疼痛史的病人要求止痛藥。護理師發現病人正在看電視且面帶笑容。何者為最合適的行動？
A client with a history of chronic pain is requesting pain medication. The nurse notes the client is laughing and watching television. Which action is most appropriate?
- ADefer the medication until the client appears to be in distress延遲給藥直到病人看起來處於痛苦狀態
- BAsk the family if the client has been acting normally詢問家屬病人行為是否正常
- CExplain that distraction is an effective pain management technique解釋轉移注意力是一種有效的疼痛管理技巧
- DAssess the client's pain level using a numeric scale✓ 正解使用數字評分量表評估病人的疼痛程度
疼痛的評估是主觀的，護理師的職責是信任並評估病人主訴的疼痛，而非依據其外在行為進行臆測。慢性疼痛（Chronic Pain）患者常發展出各種調適策略，包括分散注意力（如看電視）或在某些時刻表現出較為平靜的樣子，這並不代表他們沒有疼痛。 選項 D（使用數字評分量表評估疼痛等級）是最恰當的行動。這遵循了「病人主訴為準」的原則，提供了一個標準化的評估工具，讓病人能量化其疼痛程度（0-10分），護理師可以據此進行後續的藥物管理與非藥物介入。 選項 C（解釋轉移注意力技巧）可能為時過早，且帶有質疑病人疼痛的意味。選項 A（延後給藥至病人顯現痛苦）是危險且不符合疼痛管理的原則，病人可能因延誤治療而承受不必要的痛苦，甚至加劇疼痛。選項 B（詢問家屬）雖然可以作為輔助資訊，但不能取代病人自身的疼痛評估。
Pain is a subjective experience, so the nurse must rely on the client's self-report rather than observing external behaviors like laughter or television watching. Chronic pain patients often use coping mechanisms such as distraction, which does not negate the presence of pain; therefore, assessing the pain level using a standardized scale is the most appropriate action.