N109: Foundations in Nursing Practice

N109: Foundations in Nursing Practice Study Guide

Age/Developmental Level Age and developmental level will definitely have an influence on how pain and discomfort are perceived and what interventions should be used to maximize pain relief and comfort. The astute nurse will remember that an individual in pain of any chronological age may regress to earlier stages. • Infants respond to touch and can be comforted by being held and gently stroked. • Toddlers and preschool age children respond to discomfort or pain by getting angry or crying. A child this age can be distracted from pain, but can also be comforted by being held. • The school-age child is beginning to reach the age of reason, so the nurse may be able to talk to the child and provide education about procedures and treatments that might cause pain or discomfort. • Adolescents may see showing signs of pain or discomfort as a sign of weakness, so they may be reluctant to talk about the experience. By this age, many individuals will be open to using alternative methods for managing pain and promoting comfort. • The young and middle-aged adult may have developed more gender and culturally based behaviors and may be unwilling to directly confront the need for pain relief or comfort. The nurse can intervene by helping the adult address behaviors that may not be compatible with maximum comfort and pain relief, and by giving the adult control over which techniques will be attempted. • For the elderly adult, whomay see discomfort and pain as an expected part of the aging process and who may not report signs and symptoms, the assessment is particularly important and a full health history is critical. At this stage, the individual may have diminished sense perception, so symptoms of pain may be identified as fatigue and loss of appetite. The elderly may be concerned that reporting symptoms of pain may result in the need for supervised care and decreased independence. Cultural/Spiritual Beliefs Cultural and religious beliefs and values can have an impact on the responses to pain and discomfort. Individuals from different ethnic and racial backgrounds tend to have different ways of expressing negative emotions and different means of responding to pain and discomfort. In addition, different cultures and religions may have specific rituals associated with discomfort, pain, and pain control. The astute nurse will include an assessment of those variables in his initial and ongoing evaluations of the patient from anotherculture. Physical Condition For an individual who is already hurt or ill, the fatigue that accompanies the illness may increase the perception of pain and discomfort. Decreased appetite may result in poor nutrition, which can also exacerbate the problem and the symptoms of pain and discomfort. A hospitalized patient whose sleep is constantly interrupted may also experience increased pain and discomfort. Environmental Factors The environment can have an enormous impact on the patient’s perception of pain and comfort. If the environment is too cold, too hot, or too noisy the patient may not be able to rest and the resulting fatigue may lead to increased discomfort. Cold, wet weather or very hot weather may also adversely

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