If a patient experiences pain who cannot communicate effectively, the nurse should take which action first?

• A. Use nonverbal cues and ask family about pain expression
• B. Ignore pain
• C. Administer analgesia without assessment
• D. Do nothing

Answer: (A)

Assessing pain when a patient cannot communicate relies on observing nonverbal cues and gathering information from those who know the patient well. Look for signs such as facial grimacing, restlessness, vocalizations, guarding a body part, or changes in behavior and activity that suggest discomfort. Since the patient can’t self-report, input from family or caregivers is invaluable—they can describe how the patient typically shows pain and what level of distress they notice in different situations. In practice, use a validated pain observation tool designed for nonverbal adults (for example, CPOT or BPS) to quantify the pain and guide treatment. After assessing, provide appropriate analgesia and reassess to confirm relief. Ignoring pain, administering analgesia without assessment, or doing nothing would fail to address the patient’s suffering and could lead to worse outcomes.