Quia
Comfort, Rest, and Sleep -Pain
* Comfort, rest, and sleep are needed for well-being.
* The total person is affected by comfort, rest, and sleep problems.
* Discomfort and pain can be physical or emotional.
* Rest and sleep restore energy and well-being.
* Illness and injury increase the need for rest and sleep.
* COMFORT
* These OBRA room requirements promote comfort:
* No more than four persons in a room
* A suspended curtain that goes around the bed for privacy
* A bed of proper height and size for the person
* A clean, comfortable mattress
* Linens (sheets, blankets, spreads) that suit weather and climate
* A clean and orderly room
* An odor-free room
* A room temperature between 71( F and 81( F
* An acceptable noise level
* Adequate ventilation and room humidity
* Appropriate lighting
* PAIN
* Pain or discomfort means to ache, hurt, or be sore.
* Comfort and discomfort are subjective.
* You must rely on what the person says.
* If a person complains of pain or discomfort, the person has pain or discomfort.
* Pain is a warning from the body.
* Acute pain is felt suddenly from injury, disease, trauma, or surgery.
* It usually lasts less than 6 months.
* Chronic pain lasts longer than 6 months.
* There is no longer tissue damage.
* Radiating pain is felt at the site of tissue damage and in nearby areas.
* Phantom pain is felt in a body part that is no longer there.
* Factors affecting pain
* Past experience
* Pain can cause anxiety.
* Anxiety increases how much pain the person feels.
* Rest and sleep
* The more a person thinks about the pain, the worse it seems.
* Personal and family duties affect pain responses.
* The value or meaning of pain
* Support from others
* Culture
* Illness
* Age
* Persons with dementia may not be able to tell you about their pain.
* Report any changes in a person’s usual behavior to the nurse.
* The nurse needs this information to assess the person’s pain:
* Location
* Onset and duration
* Intensity
* Description
* Factors causing pain (precipitating factors)
* Factors affecting pain
* Vital signs
* Other signs and symptoms
* Nursing measures
* The nurse uses the nursing process to promote comfort and relieve pain.
* Distraction means to change the person’s center of attention.
* Relaxation means to be free from mental and physical stress.
* Guided imagery is creating and focusing on an image.
* Doctors often order drugs to control or relieve pain.
* YOU CAN PROMOTE REST BY:
* Meeting physical needs
* Meeting thirst, hunger, and elimination needs
* Assisting the person to a comfortable position and good alignment
* Providing a quiet setting
* Providing a clean, dry, and wrinkle-free bed
* Providing a clean, neat, and uncluttered room
* Meeting safety and security needs
* Keeping the signal light within reach
* Explaining the reasons for care
* Explaining how care is given
* Following the person’s routines and rituals whenever possible
* Promoting love and belonging needs
* Visits or calls from family and friends
* Reading cards and letters
* Promoting self-esteem needs
* Allowing personal choice in sleepwear
* Assisting with hygiene and grooming as needed
* SLEEP IS A BASIC NEED
* It lets the mind and body rest.
* The body saves energy.
* Body functions slow.
* Vital signs are lower than when awake.
* Tissue healing and repair occur.
* Sleep lowers stress, tension, and anxiety.
* It refreshes and renews the person.
* Circadian rhythm is a daily rhythm based on a 24-hour cycle.
* Circadian rhythm includes a sleep-wake cycle.
* Health care often interferes with a person’s circadian rhythm and the sleep-wake cycle.
* There are two phases of sleep.
* NREM sleep (non-REM sleep) is the phase of sleep in which there is no rapid eye movement.
* The rapid eye movement phase is called REM sleep.
* Sleep needs vary for each age-group.
* The amount needed decreases with age.
* Factors affecting sleep
* Illness
* Nutrition
* Exercise
* Environment
* Drugs and other substances
* Lifestyle changes
* Emotional problems
* Insomnia is a chronic condition in which the person cannot sleep or stay asleep all night.
* There are three forms of insomnia:
* Cannot fall asleep
* Cannot stay asleep
* Awakens early and cannot fall back asleep
* With sleep deprivation, the amount and quality of sleep are decreased.
* Sleepwalking
* The person leaves the bed and walks about.
* The person is not aware of sleepwalking.
* The event may last 3 to 4 minutes or longer.
* You need to protect the person from injury and falling; guide the person back to bed and waken the person gently.
* Promoting sleep
* The nurse assesses the person’s sleep patterns.
* Measures are planned to promote sleep.
* Follow the care plan.
* Report your observations about how the person slept.
* The person is involved in planning care.
* In persons with Alzheimer’s disease and other dementias:
* Night wandering is common.
* Restlessness and confusion often increase at night.
* QUALITY OF LIFE
* Comfort, rest, and sleep are needed for quality of life and well-being.
* OBRA has requirements that promote comfort, rest, and sleep.
* The right to personal choice and taking part in planning care promote comfort, rest, and sleep.
* Residents have the right to have pain assessed and managed.
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