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Unit 10

Unit 10. Comfort, Pain, Rest, and Sleep. Objectives. Spell and define terms. Explain how loud noise affects patients and hospital staff. Explain why nursing comfort measures are important to patients’ well-being. Objectives. List six observations to make and report for patients having pain.

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Unit 10

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  1. Unit 10 Comfort, Pain, Rest, and Sleep

  2. Objectives • Spell and define terms. • Explain how loud noise affects patients and hospital staff. • Explain why nursing comfort measures are important to patients’ well-being.

  3. Objectives • List six observations to make and report for patients having pain. • Describe nursing assistant measures to increase comfort and relieve pain. • State the purpose of the pain rating scale and briefly describe how the pain scales are used.

  4. Objectives • List nursing comfort measures that promote rest. • Describe the phases of the sleep cycle and the importance of each. • List nursing measures to promote sleep.

  5. Noise • Excessive noise: • Delays healing • Impairs immune system function • Increases heart rate and blood pressure • Causes patients to feel stressed and anxious

  6. Noise • Excessive noise: • Interferes with sleep • May trigger wandering in confused patients • May cause patient dissatisfaction with care

  7. Noise • In one health care study: • Staff felt noise caused them to feel agitated, irritable, stressed, or exhausted • Staff believed they made more errors when the unit was noisy • Noise made it difficult to focus on conversation

  8. Noise • In one health care study: • Listening to conversation and having to speak louder in a noisy environment caused staff fatigue • Nursing assistants should do everything possible to reduce noise on the unit

  9. Patient Comfort • All humans need comfort, rest, and sleep for physical and emotional well-being, health, and wellness • Comfortis a state of physical and emotional well-being • Patient is calm and relaxed • Is not in pain or upset

  10. Pain • A state of discomfort that is unpleasant for the patient • Always a warning that something is wrong

  11. Pain • Patient’s self-report of pain is the most accurate indicator of the existence and intensity of pain • Should be respected and believed

  12. Types of Pain • Acute pain occurs suddenly and without warning • It is usually the result of tissue damage • From an injury or surgery • Pain decreases over time • As healing takes place

  13. Types of Pain • Persistent pain may also be called chronic pain • Lasts longer than six months • Intermittent or constant • Usually the result of a chronic medical condition

  14. Types of Pain • Phantom pain • Results from an amputation • Patient has had a body part, such as a leg removed, but complains of pain in the toes • Pain is real, not imaginary

  15. Types of Pain • Radiating pain • Moves from the site of origin to other areas • Pain of a heart attack radiating from the chest to the jaw or arm

  16. Patients’ Responses to Pain • Patients’ responses to pain vary widely • Some individuals do not feel pain as acutely as others • Some try to ignore pain

  17. Patients’ Responses to Pain • Other patients may try to deny pain because they are afraid of what it may mean • Unrelieved pain • Has the potential to affect all areas of the patient’s life

  18. Identifying Patients in Pain and at Risk for Pain • Pain is a serious condition that affects patients’ well-being and quality of life • Patients have the right to timely pain assessment and management • Never question the validity of the patient’s complaints of pain

  19. Identifying Patients in Pain and at Risk for Pain • Patients may be smiling, talking, or sleeping and still be having pain • Vital signs may be normal. • Always avoid making assumptions about a patient’s pain

  20. Observing and Reporting Signs and Symptoms of Pain • Pain always requires further intervention • It should never be ignored • Always report verbal complaints of pain • Describe the pain in the patient’s exact words

  21. Golden Rule for Pain Relief • Whatever is painful to adults is painful to children • Unless proven otherwise • Pain control should be based on scientific facts • Not personal beliefs or opinions (Donna Wong, PhD, RN, PNP, FAAN)

  22. Golden Rule for Pain Relief • Never lie to a child when asked if a procedure will hurt • Admit that it will • Say that you will be there and make the child as comfortable as possible (Donna Wong, PhD, RN, PNP, FAAN)

  23. Pain Assessment Scales • Nurse may use a pain scale to help assess and manage a patient’s pain • The scale is a tool for communication • Patient selects the scale that best helps him or her describe the pain • Refer to Figures 10–5A and 10-5B

  24. Pain Hierarchy • Patient’s self report of pain • Forms foundation of the pain hierarchy scale • Most accurate and reliable source of information related to pain the person is experiencing • (Refer to Figure 10-6)

  25. Pain Hierarchy

  26. FACES Pain Rating Scale • FACES scale may be used for both children and adults

  27. Other Pain Rating Scales • Numeric scales are used to rate the pain by number • Such as zero for no pain • 10 being the worst pain possible • Word scales • Used to help patient select words to describe the level and intensity of pain • See Figure 10-5B

  28. Other Pain Rating Scales

  29. Managing Pain • Unrelieved pain • Has a negative effect on the patient’s health and functional status • Notify the nurse as soon as the patient complains • Before the pain becomes severe or out of control

  30. Managing Pain • Check on the patient after pain medicine has been given • Inform the nurse if the pain has not been relieved

  31. Planning Patient Care • Plan to give care after the patient has relieved pain-relieving medication • Provide nursing comfort measures, such as a backrub to help relieve pain and cause the patient to relax • Monitor the patient’s body language for signs of pain

  32. Rest • State of mental and physical comfort, calmness, and relaxation

  33. Sleep • Period of continuous or intermittent unconsciousness in which a person’s physical movements are decreased • Sleep is a basic need of all humans, as it allows the mind and body to rest

  34. The Sleep Cycle • Each person has a sleep-wake cycle • An internal biological clock • Tells a person when it is time to sleep and when it is time to wake up • Refer to Figure 10–10

  35. The Sleep Cycle

  36. Sleep Disorders • Sleep has been studied extensively • Some facilities have units and clinics that specialize in the diagnosis and treatment of sleep disorders

  37. Sleep Disorders • Most common sleep disorders are: • Insomnia • Hypersomnia • Narcolepsy • Sleep apnea • Sleep deprivation

  38. Nursing Assistant Measures to Promote Comfort, Rest, and Sleep • Basic nursing comfort measures • Those used to relieve pain are effective in helping patients rest and sleep • Specific measures for each patient will be listed in the care plan

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