BASIC NEEDS MOD B

UNIT 10: COMFORT, PAIN, REST, AND SLEEP All humans need comfort, rest, and sleep for physical and emotional well-being, health, and wellness

Comfort - state of physical and emotional well-being Patient is calm and relaxed Is not in pain or upset

COMFORT

Excessive noise Delays healing Impairs immune system function Increases heart rate and blood pressure Causes patients to feel stressed and anxious

Interferes with sleep May trigger wandering in confused patients May cause patient dissatisfaction with care

PHYSICAL NEEDS P. 120

Maslow’s hierarchy of needs: Figure 9-8!!

You need to fulfill most basic (physical) human needs before you can go to next step

•Shelter: room, temperature, maintenance

•Oxygen: help pt breath by body positioning (HOB up), O2 via Nasal cannula/mask

•Food: right food, right temperature, right environment (noise, odors), increase independence by letting pt eat himself, but assist if needed

•Sleep: need to be free of pain, hunger, thirst, need to eliminate, noise

•Elimination: bathing, encourage right diet (fiber, water), provide help with elimination

•Physical activity: promote by helping to ambulate, encourage, ROM

SECURITY/SAFETY – EMOTIONAL NEEDS P. 121 If physical needs are not met, security/safety can not be met

For security/safety Maintain safe environment Know how to respond to emergencies Implement pt care plan

If no Security/safety – then no love and affection; everyone needs to feel loved

For emotional needs Protect self-esteem: be aware of pt’s feelings of fear/loneliness/uncertainty Help maintain grooming and appearance Give sincere complements Respect privacy, don’t judge, recognize intimacy is a basic human need, discourage advances from pts

Use hugs, smiles, pat on shoulders, clasp of hands, backrubs

PAIN P. 130 Pain is discomfort that is unpleasant; considered the “fifth vital sign”,

Pain is ALWAYS a sign that something is wrong and should not be ignored! types:

Acute: sudden, without warning

Chronic (persistent): lasts longer than 6 months, may be intermittent or constant

Phantom pain: after amputation, feeling that amputated limb is hurting – Pain is real!

Radiating pain: pain moves ex. Heart attack-pain may radiate from chest to jaw or arm

Pain is what the patient says it is; pt’s self-report is the most accurate and reliable indicator of existence and intensity of pain – not the nurse, not the family member

Pain needs to be reported to the supervising nurse promptly

PAIN

• FACES scale may be used for both children and adults

PAIN P. 130 S/S of pain: Facial expressions, grimacing, refusal to move, moaning, crying, yelling, screaming Clutching a body part Stiff, ridged or limited movement Sudden change in behavior: loud when usually quiet, agitated/combative, still and withdrawn

when usually active and outgoing

Assessing pain – Pain scale Figure 10-5A p. 132 Pain is assessed as a number ex. 5/10 or 2/10, 0=no pain at all, 10=the worst pain ever felt In order to report pain to your supervising nurse, you need to know:

Vital signs, skin color Location of pain Radiating? Time of onset Frequency (how often) Quality/Character of pain: throbbing, burning, sharp, dull, continuous, intermittent Intensity – pain scale What makes it worse/ what makes it better

PAIN

Plan to give care after the patient has relieved pain-relieving medication

Provide nursing comfort measures to help relieve pain: Back rubs Reposition to relieve pain and muscle spasms Maintain comfortable environment Avoid sudden, jerking movements when moving patient See list p. 134

REST

State of mental and physical comfort, calmness, and relaxation All basic needs have to be met before rest can occur

SLEEP

Period of continuous or intermittent unconsciousness

Basic need of all humans

necessary for body and mind to function properly

Factors interfering with sleep (p. 136), ex. Pain, hunger, thirst, need to eliminate, illness, exercise, noise, temperature, medications, caffeine, anxiety etc.

SLEEP

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

NREM: Stage 1+2: easily awaken

NREM: Stage 3+4: deep sleep

REM: dreams occur

Cycle lasts from 60-120 minutes

SLEEP DISORDERS

Insomnia: wake up early, can’t fall asleep, wake up in the middle of the night

Hypersomnia: excessive sleeping

Narcolepsy: sudden, uncontrollable, unpredictable urges to fall asleep during the day

Sleep apnea: breathing stops for >10sec, waking up patient

Sleep deprivation: prolonged sleep loss

UNIT 11: CULTURAL SENSITIVITY The United States is a nation of people whose ancestors came primarily from other countries.

As a health care provider, you are expected to show sensitivity to the individuality and cultural heritage of each patient.

RACE, ETHNICITY, AND CULTURE

Race Classification of people according to shared physical characteristics

Ethnicity Special groups within a race as defined by national origin and/or culture

Culture The way a particular group views the world Set of traditions that are passed on from generation to generation

TRADITIONS

Customs and practices followed by members of a culture and passed from generation to generation

Although you may not observe the same customs or practices You should respect the traditions of your patients

CULTURAL AND RELIGIOUS GARMENTS

Members of some groups are required to wear special clothing with a religious significance

Some groups require that their members keep various parts of their bodies covered Such as covering the head during prayer

Respect each patient’s cultural and religious beliefs Do all you can to help them comply with their cultural and religious clothing requirements

RITUALS ASSOCIATED WITH WASHING

Members of some groups have rituals they must perform involving the body Washing before prayer In some cultures, washing is required at certain times of the day or before and after specified activities

Assist your patient by setting up supplies

Respect his or her religious and cultural washing rituals

HOMEWORK

Read units in textbook, then do

Review questions in textbook p. 140: True/False, 30, 31, 34

Workbook p. 62-63: True/False (1-24)