MNA Mosbys Long Term Care Assistant Chapter 24
MNA Mosby’s Long Term Care Assistant Chapter 24 Comfort, Rest and Sleep
Comfort State of well being No physical and emotional pain OBRA has certain room requirements to promote comfort
Comfort OBRA requirements: Odor free No more then 4 to a room Temp btw 71 – 81 Clean, comfortable Curtain for privacy Appropriate linens Appropriate lighting Adequate ventilation
Pain Subjective A warning from the body Types: Acute Sudden, last short time Chronic Lasts longer then 6 months, constant or on and off. Felt at site of tissue damage and in nearby areas Felt in a body part that is no longer there Radiating Phantom
Factors effecting pain Past experience Anxiety Rest and Sleep Attention Personal and family duties Value or meaning of pain Support from others Culture Age/illness
Words Used to Describe Pain Aching Piercing Burning Pressure Cramping Sharp Crushing Dull Sore Squeezing Stabbing Gnawing Throbbing Knifelike Vise-like
Signs and Symptoms Location Onset and Duration On a scale of 1 - 10 Intensity 10 is the worst Description Factors causing pain Vital signs Other signs and symptoms
Nursing Measures for Pain control Distraction - change the person’s center of attention Relaxation - free from mental or physical stress Guided Imagery - creating and focusing on an image Watch for S&S from drugs used to relieve pain. Wait 1 hour after pain medicine to provide assistance with ADLs.
Rest Being calm, at ease and relaxed Reading, music, hobbies You can promote rest by meeting patient’s needs: • Physical • Safety and security • Love and belonging • Self-esteem Injured or ill people need to rest more often
Sleep A state of unconsciousness, reduced voluntary muscle activity and lowered metabolism A basic need A person thinks and functions better after sleep Insomnia – inability to fall asleep or stay asleep.
Sleep Two phases of sleep: NREM – non rapid eye movement. Starting to fall asleep REM – rapid eye movement. Deep sleep Need for sleep decreases with age. Avg. sleep req. for older adults: 5 – 7 hours
Factors Effecting Sleep Illness - need for sleep Nutrition - sleep needs with weight gain. Foods with caffeine prevent sleep Exercise - improves health and fitness. Improves sleep Environment
Factors Effecting Sleep Drugs and other substances Life style changes Emotional problems - fear, worry, anxiety interfere with sleep
Nursing Measures to Promote Sleep Organize care for uninterrupted sleep Provide comfortable room temp Avoid caffeine Have the resident void before bedtime Follow bedtime rituals
Nursing Measures to Promote Sleep Dress in comfortable nightwear Reduce noise Darken the room Make sure linens, depends are clean & dry Position in good alignment Back massage
Sleep Walking Protect the resident from injury Guide the resident back to bed Gently wake the resident
Residents with Dementia Sleep problems are common Restlessness & confusion @ night Allow safe wandering if possible Redirect to room
Review Pain is an objective sign. True or False
Review Person’s with dementia will usually sleep well at night. ? True False
Review Pain that is sudden and short lasting is called Acute pain __________
Review The nurse gave Mr. Johnson a drug for pain. You should wait how long before providing assistance with ADLs? One hour
Review The inability to fall asleep or stay asleep is insomnia ______________.
Review Feeling pain in a body part that is no longer there: Phantom pain ___________.
Review What is REM sleep? Rapid eye movement: deep sleep
Review HS Hours of sleep Ad lib As desired prn As needed Stat immediately qod Every other day
Review Bid Twice a day Tid Three times a day C with S without X except
Review Mr. Marshall has dementia. He cannot tell you that he is in pain. How can you tell? His behavior will change
Review Use the resident’s exact words when reporting pain to the nurse. True or False
Review You find a resident sleepwalking. You should do all of the following except: A. Protect the resident from injury B. Guide the resident back to bed C. Gently wake the resident D. Turn on the lights
What are some words used to describe pain? Aching Burning Cramping Crushing Dull Gnawing Knifelike Piercing Pressure Sharp Sore Squeezing Stabbing Throbbing Vise-like
Review Mr. Parker is 72 years old. 5 -7 He needs approx. ____ hours of sleep each night.
Questions? ?
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