comfort

Question 1

aspects of comfort

Answer 1

• 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

Question 2

kolcaba’s comfort theory

Answer 2

• 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)

Question 3

definition of pain

Answer 3

• 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

Question 4

types of pain

Answer 4

• 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

Question 5

pain threshold

Answer 5

• Amount of stimulation necessary to feel pain
• diff from when you’re fatigued vs well-rested

Question 6

pain reaction

Answer 6

• 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

Question 7

pain tolerance

Answer 7

• 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

Question 8

other symptoms that alter comfort

Answer 8

• Nausea
• Pruritis (itching)
• Fatigue
• Anxiety

Question 9

nursing ASSESSMENT of comfort: nursing history COLDSPA

Answer 9

• 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?

Question 10

Routine Clinical Approach to Pain Assessment and
Management: ABCDE

Answer 10

• 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.

Question 11

nursing assessment: physical exam (objective data)

Answer 11

• 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

Question 12

nursing diagnostic categories: acute pain

Answer 12

• A sudden or abrupt onset of discomfort, distress, or suffering due to irritation or stimulation of sensory nerves, usually of a short duration

Question 13

nursing diagnostic categories: chronic pain

Answer 13

• Constant discomfort, distress, or suffering due to irritation of sensory
  nerves, usually of a long duration

Question 14

nursing diagnostic categories: nausea

Answer 14

• An unpleasant feeling or sensation that often precedes vomiting

Question 15

projected outcomes

Answer 15

• Person rates pain in acceptable range
• NOC: Pain control, comfort level

Question 16

nursing interventions

Answer 16

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

Question 17

Nursing Interventions Classifications

Answer 17

• pain management
• analgesic administration
• simple relaxation therapy (non-pharmacological)

Question 18

evaluation

Answer 18

• Pain Rating _____/10
• Relief of associated symptoms
• what pt says

Question 19

which of the following is a false statement about pain?

Answer 19

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

Question 20

Chronic Pain is more likely to

Answer 20

A. Cause parasympathetic symptoms
B. Occur for 3 months
C. Stabbing in quality (more acute)
D. Felt as phantom pain (more acute)

Question 21

Which statement best reflects the nurse’s assessment of the 5th vital sign?

Answer 21

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)

Question 22

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….

Answer 22

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

Question 23

The nurse recognizes
that which of the following is a modifiable contributor
to a patients perception of pain?

Answer 23

A. Age and Gender
B. Anxiety and Fear (CORRECT. we can do something abt this)
C. Culture
D. Previous pain experience