Nursing 109

N109: Foundations in Nursing Practice Study Guide

Psychological Factors For patients with an alteration in comfort or those experiencing pain, what is understood about the meaning of comfort, pain, disease, and disability will play a part in the presentation of the problem and the effectiveness of treatment and interventions for the discomfort. Socioeconomic Factors For the economically disadvantaged, routine healthcare may be inaccessible. This may from a lack of insurance, lack of transportation, or lack of funds for necessary medication and equipment to provide comfort and pain relief. In addition, social support systems can have a huge impact on the individual’s perception of pain and discomfort since loneliness and isolation tend to exacerbate feelings of discomfort. Individual Preferences The astute nurse will ask what comfort and pain relieving measures the patient has used successfully in the past, and after first determining if the measures are safe, then encourages those same measures be used during this episode of discomfort or pain. The nurse must also recognize that certain types of discomfort or pain may occur at a certain time of day and should intervene appropriately. For example, a young adult with rheumatoid arthritis may have increased discomfort in the morning; the nurse should plan strenuous procedures and treatments for later in the day when the individual has had an opportunity to be up for awhile. 2.8 Non-Pharmacological Treatment Modalities The nurse should know several different comfort measures that can be employed to help provide comfort and relief from pain. While the nurse may not have expertise in all the techniques, it is important to know about all of them and to have access to other team members who may be able to provide the interventions: • Relaxation techniques: Stress is one of the primary causes of pain and discomfort and relaxation techniques are an easy way to intervene with stress. Some of these techniques include: o Visual imagery, in which the nurse guides the individual to imagine a peaceful setting while concentrating on slow, even breathing. Encourage the individual to imagine the sounds, sights, and smells that might be in the setting. o Progressive muscle relaxation encourages the individual to focus on slowly tensing and then relaxing each muscle group. • Yoga is a specific physical and mental discipline that can be helpful in attaining tranquility. A time of illness may not be the best time to teach yoga techniques, but if the patient is already a practitioner, this may be a perfect intervention for providing comfort and pain relief. • Deep breathing may be an effective technique for many. The key to deep breathing is to breathe deeply from the abdomen, getting as much fresh air as possible into the lungs. When taking deep breaths from the abdomen, rather than shallow breaths from the upper chest, more oxygen is taken in and anxiety and stress are decreased.

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