comfort Flashcards
aspects of comfort
- Physiologic: body temp, pressure, itching, nausea
- Psychological: stressors, happy, sad, etc
- Sociocultural: environment = having a place to live
- Spiritual: meaning and purpose in your life
kolcaba’s comfort theory
- Relief: needs are met
- Ease: they are calm & content
- Transcendence: performance. able to do more, participate in activities
- Comfort care is a nursing art that entails the process of comforting actions by a nurse for a patient
- Holistic (involves all forms of adaptation. physically, mentally, spirituality), individualistic (what is comforting for one might not be for someone else)
- Creative (how to make them comfy. trying diff things), efficient (getting them comfy asap)
definition of pain
- Pain is an unpleasant sensory and emotional
experience associated with actual or potential tissue damage or described in terms of such damage - Pain is whatever the experiencing person says
it is and exists whenever the person says it does
types of pain
- acute: < 6 months
- slow or sudden onset. varies from mild to severe
- chronic: > 6 months
- can limit normal fxning. continues beyond healing
- radiating: extends to nearby tissues
- referred: felt at another body area
- liver pain could be felt right side of the neck
- intractable: highly resistant to relief
- pain that is hard to be alleviated
- phantom: sensation perceived in missing body part
- leg amputated but they feel pain in big toe
pain threshold
- Amount of stimulation necessary to feel pain
- diff from when you’re fatigued vs well-rested
pain reaction
- Autonomic responses to pain
- Acute pain—sympathetic
- Chronic pain—parasympathetic (body gets used to this pain and learns how to cope w/ it)
- Influenced by past experiences, culture, mood, attitudes, emotions,
environment –> affect our rxns to pain
pain tolerance
- amount and duration of pain that person is willing to endure
Influenced By - Physiologic Factors: fatigue, anxiety, stress
- Sociocultural Factors: Ethnicity, gender, family & social support
- Age: infants have less pain tolerance than an adult
other symptoms that alter comfort
- Nausea
- Pruritis (itching)
- Fatigue
- Anxiety
nursing ASSESSMENT of comfort: nursing history COLDSPA
- Character: describe the sign or symptom (feeling, appearance, sound, smell, or taste)
- Onset: when did it begin?
- Location: where is it? does it radiate? does it occur anywhere else?
- Duration: how long does it last? does it recur?
- Severity: How bad is it? How much does it bother you? (0-10)
- Pattern: what makes it better or worse?
- Associated factors/How it Affects the client: What other symptoms occur with it? How does it affect you?
Routine Clinical Approach to Pain Assessment and
Management: ABCDE
- A: Ask about pain regularly. Assess pain systematically.
- B: Believe patient and family in their report of pain and what relieves
it. - C: Choose pain control options appropriate for the patient, family, and
setting. - D: Deliver interventions in a timely, logical, and coordinated fashion.
- E: Empower patients and their families. Enable them to control their course to the greatest extent possible.
nursing assessment: physical exam (objective data)
- Physiologic responses: Autonomic nervous system responses
- Ex: is their heart rate or BP elevated? if this is normal, it does not mean you aren’t in pain
- Behavioral responses: Moaning, grimacing, guarding
- Physical Assessment: Areas of swelling, heat, redness, increased pain with touch
nursing diagnostic categories: acute pain
- A sudden or abrupt onset of discomfort, distress, or suffering due to irritation or stimulation of sensory nerves, usually of a short duration
nursing diagnostic categories: chronic pain
- Constant discomfort, distress, or suffering due to irritation of sensory
nerves, usually of a long duration
nursing diagnostic categories: nausea
- An unpleasant feeling or sensation that often precedes vomiting
projected outcomes
- Person rates pain in acceptable range
- NOC: Pain control, comfort level
nursing interventions
A. Acknowledge client’s pain—ask about it regularly, assess it systematically
B. Reduce barriers to pain management –
C. Reducing misconceptions about pain
D. Reducing fear & anxiety
E. Control painful stimuli in patient’s environment
F. Pharmacologic management of pain
1. use of the WHO ladder
2. Patient Controlled Analgesia (in charge of their pain meds by pressing a button)
G. Non- pharmacologic—heat/ice, massage, acupressure, immobilization,
positioning, hygiene, TENS (gives shocks to relieve pain), distraction, hypnosis, guided imagery, music
Nursing Interventions Classifications
- pain management
- analgesic administration
- simple relaxation therapy (non-pharmacological)
evaluation
- Pain Rating _____/10
- Relief of associated symptoms
- what pt says
which of the following is a false statement about pain?
A. Pain occurs when the person experiencing it says it does
B. Pain is produced by tissue injury
C. Pain produces the same reactions in all persons (CORRECT)
D. Pain tolerance can change
Chronic Pain is more likely to
A. Cause parasympathetic symptoms
B. Occur for 3 months
C. Stabbing in quality (more acute)
D. Felt as phantom pain (more acute)
Which statement best reflects the nurse’s assessment of the 5th vital sign?
A. “Do you have any complaints?” (doesn’t tell us abt pain or discomfort)
B. “Are you having any discomfort right now?” (CORRECT)
C. “Is there anything I can do for you now?” (doesn’t mention pain)
D. “Do you have any complaints of pain?” (our view of pain might be their discomfort)
Your patient has the nursing diagnosis: Acute pain related to surgical incision and muscle spasms secondary to repair of fractured hip.
Which of the following is the best projected outcome statement? By discharge the patient will….
A. Demonstrate ability to ambulate with walker (doesn’t have to do with the goal)
B. Deny any complaint of pain (a goal)
C. Report that he is sleeping better (doesn’t necessarily mean the pain is gone)
D. Rate pain as a 1-2 on a 0-10 scale
The nurse recognizes
that which of the following is a modifiable contributor
to a patients perception of pain?
A. Age and Gender
B. Anxiety and Fear (CORRECT. we can do something abt this)
C. Culture
D. Previous pain experience
