Environmental Management: Comfort to Reduce Pain

Environmental Management: Comfort to Reduce Pain

Pain Management   January 25, 2017

Donahuwe (1989) sums up "through a sense of comfort and actions for comfort, nurses provide strength, hope, consolation, support, encouragement and assistance." A variety of nursing theory states comfort as the basic needs of the client which is the purpose of nursing care. The concept of the convenience of having the same subjectivity of pain. Each individual has a characteristic physiological, social, spiritual, psychological and cultural influences how they interpret pain. Kolcaba (1992) defines comfort in a consistent manner on the subjective experience kilien. Polcaba defines comfort as a state has met the basic needs of human beings. These needs include the need for reassurance (a satisfaction which improves the daily appearance), relief (needs have been met) and transcendent (state about something beyond the problem or pain).

Definition: The act of environmental manipulation to optimize patient comfort

Environmental Management: Comfort to Reduce Pain

• Providing the same room with the desired environment, if possible and appropriate.
• Limiting visitors.
• Avoid disturbing unneeded and provide time off
• Determining the source of discomfort, such as clothes were damp, the position of the pipe, tight clothes, bed linen wrinkle, and environmental irritants
• Preparing the room clean and the beds were comfortable
• Setting the room temperature comfortable for the patient, if possible
• Move or provide blankets to increase the comfort, if indicated
• Avoid unnecessary exposure, a lot of wind, too hot, and cold
• Set the lighting according to activity and the needs of patients, avoid lights directly into the eye
• Control and prevent the atmosphere is too crowded, if possible
• Facilitates personal hygiene for ensuring patient (such as wiping the forehead, using skin cream or body wash, hair and oral hygiene)
• Positioning the patient to obtain comfort (using the principles of body alignment / line of the body, supported by pillows, protect joints during movement, and pain immobilisasikan body parts)
• Monitor the skin, especially areas of the body having suppressed, as a sign of suppression or irritation
• Avoid skin and mucous membrane of irritants (such as diarrhea stool and wound drainage)

Acute Pain related to Atherosclerosis

Acute Pain related to Atherosclerosis

Nursing Diagnosis and Interventions   September 17, 2013

Nursing Care Plan for Atherosclerosis - Nursing Diagnosis : Acute Pain

Atherosclerosis is an inflammation in human blood vessels, which caused accumulation of atheromatous plaque.

Atherosclerosis (also known as arteriosclerotic vascular disease or ASVD) is a specific form of arteriosclerosis in which an artery wall thickens as a result of the accumulation of fatty materials such as cholesterol and triglyceride.

Atherosclerosis is a chronic disease that remains asymptomatic for decades. Atherosclerotic lesions, or atherosclerotic plaques are separated into two broad categories: Stable and unstable (also called vulnerable).

Clinically, atherosclerosis is typically associated with men over the age of 45. Sub-clinically, the disease begins to appear at early childhood, and perhaps even at birth. Noticeable signs can begin developing at puberty. Though symptoms are rarely exhibited in children, early screening of children for cardiovascular diseases could be beneficial to both the child and his/her relatives.


Acute Pain

Definition : Pain is whatever the experiencing person says it is, existing whenever the person says it does (McCaffery, 1968); an unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage (International Association for the Study of Pain) sudden or slow onset of any intensity from mild to severe with an anticipated or predictable end and a duration of less than 6 months (NANDA)

Defining Characteristics:

Subjective

Pain is always subjective and cannot be proved or disproved. A client's report of pain is the most reliable indicator of pain (Acute Pain Management Guideline Panel, 1992). A client with cognitive ability who can speak or point should use a pain rating scale (e.g., 0 to 10) to identify the current level of pain intensity (self-report) and determine a comfort/function goal (McCaffery, Pasero, 1999).

Objective

Expressions of pain are extremely variable and cannot be used in lieu of self-report. Neither behavior nor vital signs can substitute for the client's self-report (McCaffery, Ferrell, 1991, 1992; McCaffery, Pasero, 1999). However, observable responses to pain are helpful in clients who cannot or will not use a self-report pain rating scale. Observable responses may be loss of appetite and inability to deep breathe, ambulate, sleep, or perform activities of daily living (ADLs). Clients may show guarding, self-protective behavior, self-focusing or narrowed focus, distraction behavior ranging from crying to laughing, and muscle tension or rigidity. In sudden and severe pain, autonomic responses such as diaphoresis, blood pressure and pulse changes, pupillary dilation, or increases or decreases in respiratory rate and depth may be present.


Nursing Diagnosis for Atherosclerosis : Acute Pain related to impaired ability of blood vessels to supply oxygen to the tissues.

Having given nursing care, is expected to decrease pain, with outcomes: patient states; chest pain disappear or be in control, the patient does not seem grimace, demonstrate relaxation techniques.

Nursing Intervention

1. Monitor the characteristics of pain through verbal response, and hemodynamics (crying, pain, grimacing, can not rest, respiratory rhythm, blood pressure and changes in heat rate).
R /: Each patient has a different response to pain, verbal and hemodynamic changes in response to detecting a change in comfort.

2. Assess the picture of pain experienced by patients include: place, intensity, duration, quality, and distribution.
R /: Pain is a subjective feeling that is experienced and is described by the patient and should be compared with other diseases, so we get accurate data.

3. Provide a comfortable environment, reduce the activity, limit visitors.
R /: Helps reduce external stimuli that can add to the tranquility so that the patient can rest and the heart does not work too hard.

4. Teach relaxation techniques with a deep breath
R /: Helps relieve pain experienced by the patient psychologically which can distract the patient that is not focused on the pain experienced.

5. Observation of vital signs before and after drug administration.
R /: They can cause respiratory depression and hypotension.

Acute Pain related to Gastritis

Acute Pain related to Gastritis

Nursing Diagnosis and Interventions   September 08, 2013

Nursing Care Plan for gastritis - Nursing Diagnosis : Acute Pain

Gastritis is an inflammation of the lining of the stomach, and has many possible causes. The main acute causes are excessive alcohol consumption or prolonged use of nonsteroidal anti-inflammatory drugs (also known as NSAIDs) such as aspirin or ibuprofen. Sometimes gastritis develops after major surgery, traumatic injury, burns, or severe infections. Gastritis may also occur in those who have had weight loss surgery resulting in the banding or reconstruction of the digestive tract. Chronic causes are infection with bacteria, primarily Helicobacter pylori, chronic bile reflux, and stress; certain autoimmune disorders can cause gastritis as well. The most common symptom is abdominal upset or pain. (wikipedia)

Acute Pain

Pain is whatever the experiencing person says it is, existing whenever the person says it does (McCaffery, 1968); an unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage (International Association for the Study of Pain) sudden or slow onset of any intensity from mild to severe with an anticipated or predictable end and a duration of less than less than 6 months.

Defining Characteristics:

Subjective

Pain is always subjective and cannot be proved or disproved. A client's report of pain is the most reliable indicator of pain (Acute Pain Management Guideline Panel, 1992). A client with cognitive ability who can speak or point should use a pain rating scale (e.g., 0 to 10) to identify the current level of pain intensity (self-report) and determine a comfort/function goal (McCaffery, Pasero, 1999).

Objective

Expressions of pain are extremely variable and cannot be used in lieu of self-report. Neither behavior nor vital signs can substitute for the client's self-report (McCaffery, Ferrell, 1991, 1992; McCaffery, Pasero, 1999). However, observable responses to pain are helpful in clients who cannot or will not use a self-report pain rating scale. Observable responses may be loss of appetite and inability to deep breathe, ambulate, sleep, or perform activities of daily living (ADLs). Clients may show guarding, self-protective behavior, self-focusing or narrowed focus, distraction behavior ranging from crying to laughing, and muscle tension or rigidity. In sudden and severe pain, autonomic responses such as diaphoresis, blood pressure and pulse changes, pupillary dilation, or increases or decreases in respiratory rate and depth may be present.


Nursing Diagnosis for Gastritis : Acute Pain related to inflammation of the mucosal lining of the stomach (gastric)

Goal: Pain is reduced with no inflammation or irritation of the gastric mucosa

Outcomes:

• Pain scale is reduced
• Do not feel pain in the epigastric.
• Not grimace (no abdominal tenderness)

Gastritis Nursing Interventions and Rational:

1. Record complaints of pain, including the location, duration, intensity (scale of 0-10)
R /: Pain is not always there, but if there is to be compared with the previous patient's symptoms of pain, which can help diagnose the etiology and occurrence of bleeding complications.

2. Review the factors that increase or decrease pain.
R /: Assist in making diagnoses and treatment needs.

3. Give food a little but often as an indication for patients.
R /: Food has the effect of neutralizing acid, also destroy the gastric contents. Eating little to prevent distension.

4. Assistive range of motion exercises active / passive.
R /: Reduce joint stiffness, pain minimize discomfort.

5. Provide frequent oral care and comfort measures (back massage, change of positions).
R /: Bad breath due to retained secretions, causing no appetite and can increase nausea. Gingivitis and dental problems can be improved.

6. Give medications as indicated.
R /: Lowering the acidity of gastric absorption or by neutralizing chemical.

Gastritis - Definition, Classification, Pathophysiology and Prevention