Unit 10 Comfort Pain Rest and Sleep Copyright

Objectives • Spell and define terms. • Explain how loud noise affects patients and

Objectives • List six observations to make and report for patients having pain. •

Objectives • List nursing comfort measures that promote rest. • Describe the phases of

Noise • Excessive noise: – Delays healing – Impairs immune system function – Increases

Noise • Excessive noise: – Interferes with sleep – May trigger wandering in confused

Noise • In one health care study: – Staff felt noise caused them to

Noise • In one health care study: – Listening to conversation and having to

Patient Comfort • All humans need comfort, rest, and sleep for physical and emotional

Pain • A state of discomfort that is unpleasant for the patient • Always

Pain • Patient’s self-report of pain is the most accurate indicator of the existence

Types of Pain • Acute pain occurs suddenly and without warning • It is

Types of Pain • Persistent pain may also be called chronic pain – Lasts

Types of Pain • Phantom pain – Results from an amputation • Patient has

Types of Pain • Radiating pain – Moves from the site of origin to

Patients’ Responses to Pain • Patients’ responses to pain vary widely • Some individuals

Patients’ Responses to Pain • Other patients may try to deny pain because they

Identifying Patients in Pain and at Risk for Pain • Pain is a serious

Identifying Patients in Pain and at Risk for Pain • Patients may be smiling,

Observing and Reporting Signs and Symptoms of Pain • Pain always requires further intervention

Golden Rule for Pain Relief • Whatever is painful to adults is painful to

Golden Rule for Pain Relief • Never lie to a child when asked if

Pain Assessment Scales • Nurse may use a pain scale to help assess and

Pain Hierarchy • Patient’s self report of pain – Forms foundation of the pain

Pain Hierarchy Copyright © 2008 Delmar Learning. All rights reserved.

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

Other Pain Rating Scales • Numeric scales are used to rate the pain by

Other Pain Rating Scales Copyright © 2008 Delmar Learning. All rights reserved.

Managing Pain • Unrelieved pain – Has a negative effect on the patient’s health

Managing Pain • Check on the patient after pain medicine has been given –

Planning Patient Care • Plan to give care after the patient has relieved pain-relieving

Rest • State of mental and physical comfort, calmness, and relaxation Copyright © 2008

Sleep • Period of continuous or intermittent unconsciousness in which a person’s physical movements

The Sleep Cycle • Each person has a sleep-wake cycle • An internal biological

The Sleep Cycle Copyright © 2008 Delmar Learning. All rights reserved.

Sleep Disorders • Sleep has been studied extensively • Some facilities have units and

Sleep Disorders • Most common sleep disorders are: – Insomnia – Hypersomnia – Narcolepsy

Nursing Assistant Measures to Promote Comfort, Rest, and Sleep • Basic nursing comfort measures

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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. Copyright © 2008 Delmar Learning. All rights reserved.

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. Copyright © 2008 Delmar Learning. All rights reserved.

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. Copyright © 2008 Delmar Learning. All rights reserved.

Noise • Excessive noise: – Delays healing – Impairs immune system function – Increases heart rate and blood pressure – Causes patients to feel stressed anxious Copyright © 2008 Delmar Learning. All rights reserved.

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 Copyright © 2008 Delmar Learning. All rights reserved.

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 Copyright © 2008 Delmar Learning. All rights reserved.

Patient Comfort • All humans need comfort, rest, and sleep for physical and emotional wellbeing, health, and wellness • Comfort is a state of physical and emotional well-being – Patient is calm and relaxed – Is not in pain or upset Copyright © 2008 Delmar Learning. All rights reserved.

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 Copyright © 2008 Delmar Learning. All rights reserved.

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 Copyright © 2008 Delmar Learning. All rights reserved.

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 Copyright © 2008 Delmar Learning. All rights reserved.

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 Copyright © 2008 Delmar Learning. All rights reserved.

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 Copyright © 2008 Delmar Learning. All rights reserved.

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 Copyright © 2008 Delmar Learning. All rights reserved.

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 Copyright © 2008 Delmar Learning. All rights reserved.

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 Copyright © 2008 Delmar Learning. All rights reserved.

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, Ph. D, RN, PNP, FAAN) Copyright © 2008 Delmar Learning. All rights reserved.

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, Ph. D, RN, PNP, FAAN) Copyright © 2008 Delmar Learning. All rights reserved.

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– 5 A and 10 -5 B Copyright © 2008 Delmar Learning. All rights reserved.

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) Copyright © 2008 Delmar Learning. All rights reserved.

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 -5 B Copyright © 2008 Delmar Learning. All rights reserved.

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 Copyright © 2008 Delmar Learning. All rights reserved.

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 Copyright © 2008 Delmar Learning. All rights reserved.

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 Copyright © 2008 Delmar Learning. All rights reserved.

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 Copyright © 2008 Delmar Learning. All rights reserved.

Sleep Disorders • Sleep has been studied extensively • Some facilities have units and clinics that specialize in the diagnosis and treatment of sleep disorders Copyright © 2008 Delmar Learning. All rights reserved.

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 Copyright © 2008 Delmar Learning. All rights reserved.