NANDA-I 2024-2026 edition · Reviewed November 2, 2026 by the editorial team
Diagnosis at a glance
| Code | 00132 |
|---|---|
| Label | Acute pain |
| Spanish label | Dolor agudo |
| Domain | 12. Comfort |
| Class | 1. Physical comfort |
| Type | Problem-focused |
| Status | Current |
What it means
It is pain that comes from a recent cause, such as surgery, trauma or inflammation, and that has an end in sight: it improves as the tissue heals. Nursing measures it with a scale, treats it and checks that the treatment is working.
Explanation written by our team. The official definition is in the NANDA-I 2024-2026 book.
When to use it
Clinical situations where it commonly shows up. The diagnosis is confirmed by your assessment, not by the medical diagnosis.
- Immediate and later postoperative period (surgical incisions, drains).
- Trauma: fractures, sprains, burns, contusions.
- Inflammatory or ischemic processes: appendicitis, renal colic, pancreatitis, myocardial infarction.
- Painful procedures: IV starts, wound care, drain removal.
- New-onset pain in a patient with preexisting chronic pain (document both if appropriate).
- Patients who cannot say they are in pain (intubated, newborns, dementia) who show pain behaviors on a behavioral scale.
What to assess
- Intensity with a validated scale, always the same one: 0-10 numeric or visual analog in adults; FLACC in children under 3 or people who cannot speak; PAINAD in advanced dementia.
- Location, radiation, quality (stabbing, pressure, cramping, burning) and what makes it worse or better.
- Onset and course: since when, constant or intermittent, getting worse or not.
- Behaviors: guarding, grimacing, restlessness, crying, refusing to move.
- Physiological response: heart rate, blood pressure, respiratory rate and diaphoresis. Their absence does not rule out pain.
- Effect on sleep, mobility, coughing and eating.
- Analgesics received, time of the last dose and response.
- Sedation level and respiratory rate if on opioids, and what the patient fears or believes about pain medication.
Defining characteristics
Assessment findings that support the diagnosis. They go in the "as evidenced by" part of the statement.
- Score of 4 or higher on the numeric scale, or an equivalent score on a behavioral scale.
- The patient says it hurts and points to where.
- Facial grimacing: furrowed brow, eyes squeezed shut, clenched jaw.
- Holds or guards the affected area and doesn't let anyone touch it.
- Assumes a protective position and refuses to change it.
- Avoids moving, coughing or taking deep breaths.
- Restlessness, moaning, crying or irritability.
- Heart rate, blood pressure or respiratory rate above the patient's baseline.
- Diaphoresis and pallor during pain peaks.
- Wakes up from pain or cannot sleep.
- Loses interest in surroundings, with attention focused on the pain.
Related factors
The causes nursing can act on. They go in the "related to" part of the statement.
- Recent physical injury: surgical incision, fracture, burn or puncture.
- Inflammation or lack of blood flow to an organ.
- Contact with irritating substances, such as an IV extravasation or a chemical burn.
- Insufficient analgesia or doses given late.
- A position or immobilization that puts tension on the injured area.
- Painful procedures without premedication.
- Fear of pain medication or not knowing how to ask for it in time.
- Anxiety and lack of information, which increase pain perception.
At-risk populations
- Postoperative patients, especially after abdominal, thoracic or orthopedic surgery.
- Older adults, whose pain is often underestimated.
- Newborns and young children, who cannot describe it.
- People with cognitive impairment, intubated or sedated.
- People with previous opioid use, who may need more analgesia.
Associated conditions
- Surgery and invasive procedures.
- Trauma, fractures and burns.
- Renal or biliary colic.
- Pancreatitis and appendicitis.
- Acute coronary syndrome.
- Acute herpes zoster.
How to write it (PES)
Acute pain related to physical injury agent (12-hour-old abdominal surgical incision) as evidenced by pain rated 7/10 on the numeric scale, facial grimacing, and guarding of the incision when coughing and moving.
Acute pain (00132).
The cause nursing acts on: here, the physical injury from surgery. If the pain comes from an inflammatory or ischemic process, name that agent instead.
What you observed or what the patient told you: the pain score, the behaviors and the physiological changes. Write concrete data, not “reports pain.”
Example written by our team for a fictional patient. Adapt it to your own patient's data. Build your statement with the PES generator.
Goals / expected outcomes
Written in measurable terms: what, how much and by when.
- The patient reports pain ≤3/10 on the numeric scale 60 minutes after oral analgesia or 30 minutes after IV analgesia.
- Coughs, repositions and walks with assistance without pain stopping them, within the first 24 hours.
- Sleeps for stretches of at least 4 hours without waking from pain.
- Describes at least two nonpharmacological measures that help and asks for pain medication before the pain becomes severe.
- Keeps heart rate and respiratory rate within their usual range during the shift.
Nursing interventions and rationales
| Intervention | Rationale |
|---|---|
| Assess pain with the chosen scale on admission, every shift, and before and after every analgesic dose. | What isn't measured can't be compared; always using the same scale shows the trend. |
| Give prescribed analgesia around the clock, not only PRN, in the postoperative period. | Steady levels prevent pain spikes, which are harder to control. |
| Reassess 15-30 minutes after an IV dose and 60 minutes after an oral dose. | Confirms whether the dose worked and documents it so the regimen can be adjusted with the provider. |
| Monitor sedation and respiratory rate when the patient is on opioids. | Excessive sedation appears before respiratory depression and is the most useful warning sign. |
| Use nonpharmacological measures: comfortable positioning, a pillow over the incision when coughing, cold packs for recent injuries, slow breathing. | They add relief and reduce the amount of analgesic needed. |
| Schedule painful procedures after the analgesic reaches its peak effect. | Dressing changes and mobilization are better tolerated with premedication. |
| Teach the patient to speak up at the first increase in pain and to use the scale. | Asking for pain medication early keeps pain from reaching 8 or 9. |
| Notify the provider if pain stays at 4 or higher after two reassessments, or if it changes in quality or location. | It may mean the regimen isn't enough or that there is a complication, such as bleeding or infection. |
| Explain which pain medications the patient is receiving and address fears about “addiction.” | That fear leads many patients to tough out the pain instead of asking for relief. |
NOC outcomes and NIC interventions
Outcomes (NOC) and interventions (NIC) that published sources link to this diagnosis. Pick the ones that fit your patient.
NOC outcomes
- 1605Pain Control
- 2101Pain: Disruptive Effects
- 2102Pain Level
NIC interventions
- 1400Pain Management
- 2210Analgesic Administration
- 2870Postanesthesia Care
- 3440Incision Site Care
Linkages drawn from care plans published by health services, universities and nursing journals. Labels may vary depending on the NIC and NOC edition your facility uses.
Case study: After an open appendectomy
Patient. A 34-year-old man, 10 hours after an open appendectomy for complicated appendicitis. He is on the surgical floor and calls for help because he can't move in bed.
Assessment
- Pain 7/10 on the numeric scale in the right lower quadrant, rising to 9/10 when coughing.
- Heart rate 106 bpm, blood pressure 138/88 mmHg (baseline 120/78).
- Respiratory rate 22, shallow; SpO2 95% on room air.
- Holds the incision with both hands and keeps his legs flexed.
- Last analgesic dose 6 hours ago; it was ordered PRN and he didn't ask for it.
- Says he preferred to tough it out because “strong painkillers are bad for you.”
Nursing diagnosis
Acute pain related to physical injury agent (surgical incision) as evidenced by pain rated 7/10 rising to 9/10 with coughing, heart rate of 106 bpm, guarding of the incision, and protective positioning.
Goal
The patient reports pain ≤3/10 within 60 minutes of analgesia and coughs while splinting the incision with a pillow within the next 4 hours.
Interventions
- Give the prescribed analgesic and discuss switching to around-the-clock dosing with the provider.
- Reassess pain, sedation and respiratory rate at 30 and 60 minutes.
- Teach him to splint the incision with a pillow when coughing and turning.
- Address his concerns about pain medication and ask him to call when pain reaches 4.
- Schedule his first walk after the analgesic's peak effect.
Evaluation
At 60 minutes he reports pain at 3/10, heart rate 88 bpm, and coughs while splinting with the pillow. At 24 hours he walks in the hallway with pain at 2-3/10 on scheduled analgesia. The diagnosis stays active while he needs analgesics and is resolved at discharge if pain remains controlled.
How it differs from similar diagnoses
- Chronic pain (00133): Use it when pain lasts, or is expected to last, more than three months. Acute pain has a predictable end.
- Chronic pain syndrome (00255): Beyond persistent pain, there is an effect on sleep, mood or daily life that forms a syndrome.
- Labor pain (00256): Specific to the pain of labor and delivery.
- Ineffective pain self-management (00418): The focus is not the pain itself but the person's difficulty managing it on their own in daily life.
Common mistakes
- Writing “Acute pain related to surgery”: surgery is the condition; the factor is the physical injury it causes.
- Leaving the pain score out of the evidence.
- Keeping the diagnosis open days after the pain is controlled.
- Assuming there is no pain because vital signs are normal.
- Switching scales between shifts, which makes the scores impossible to compare.
Assessment scales
Used in these conditions
Other diagnoses in the Physical comfort class
Domain 12, Comfort. See every diagnosis in this domain.
Frequently asked questions
What is the NANDA code for acute pain?
00132, in Domain 12 (Comfort), Class 1 (Physical comfort). It is still current in the 2024-2026 edition.
How long does acute pain last according to NANDA?
It has a predictable end and generally lasts less than three months. If it goes on longer, assess for chronic pain.
What pain scale do I use for an intubated patient or a patient with dementia?
A behavioral scale: FLACC for young children or patients who cannot communicate, PAINAD for advanced dementia.
Can a patient have acute pain and chronic pain at the same time?
Yes. A patient with chronic low back pain who just had gallbladder surgery has both, and each one gets its own plan.
When do I resolve the acute pain diagnosis?
When pain stays at the agreed goal (for example, ≤3/10) and doesn't interfere with sleep, mobility or coughing. If it is controlled only with analgesics, you can keep it until they are discontinued.
Study material: the explanation, characteristics, factors, examples and case study on this page were written by our editorial team. The official text for Acute pain (00132) is in NANDA International Nursing Diagnoses: Definitions and Classification 2024-2026. This page does not replace clinical judgment or your facility's protocols.
Classification sources: NANDA-I 2024-2026, Thieme supplement · Elsevier summary of changes · Spanish edition table of contents · NOC/NIC: source 1, source 2. Reviewed November 2, 2026.