Nursing diagnosis – READINESS FOR ENHANCED COMFORT

READINESS  FOR  ENHANCED  COMFORT

DEFINITION

A pattern of ease, relief, and transcendence in physical, psychospiritual

environmental, and/or social dimensions that can be strengthened

DEFINING CHARACTERISTICS

• Expresses desire to enhance comfort

• Expresses desire to enhance feelings of contentment

• Expresses desire to enhance relaxation

• Expresses desire to enhance resolution of complaints

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Behavior

• Communication

• Coping

EXPECTED OUTCOMES

The patient will

• Express positive perception of nursing assistance to perform activi-

ties that promote comfort.

• Experience physical and psychological ease.

• Develop plans to optimize level of comfort.

• Report an increase in relaxation.

SUGGESTED NOC OUTCOMES

Coping Enhancement; Client Satisfaction; Comfort Level; Emotional

support; Environmental Management

INTERVENTIONS AND RATIONALES

Determine: Assess patient’s satisfaction with the amount of assistance

the nurse is presently offering to determine whether the patient per-

ceives self as performing physical, psychosocial, and spiritual activi-

ties as a level that is comfortable for self-changes in status.

Determine what enhancements to care can be made to provide the

patient a greater degree of comfort.

Ask for feedback from the patient at least once a day to evaluate

progress.

Perform: Adjust environmental factors, where possible, to enhance

the patient’s feeling of a safe and comfortable environment.

Assist patient with bathing, feeding, and toileting to ensure that

his or her needs are met.

Turn and reposition patient every 2 hr to promote comfort.

Inform: Teach patient when he or she is ready about his or her dis-

ease. Present only what patient is able and willing to absorb to pre-

vent him or her from becoming overwhelmed.

Avoid insisting that the patient accept information. Readiness is

an important factor in adult education. Provide both patient and

family with written information such as pamphlets and so forth.

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Teach the patient and family techniques for relaxation such as

guided imagery to promote comfort and reduce anxiety.

Attend: Provide emotional support and encouragement to help

improve ability of patient to cope with the diagnosis.

Involve patient in planning and decision making. Having the abil-

ity to participate will encourage greater compliance with the plan

and enhance comfort.

Encourage patient to communicate with others, asking questions

and clarifying concerns based on readiness. This will enhance the

patient’s learning ability.

Manage: Maintain frequent communication with physicians and

other staff to determine what the patient is being told about his or

her condition.

Collaboration will foster consistency in what the patient is being

told.

Refer patient to a mental health professional/grief counselor if

denial interferes with ability of patient to function within limits.

SUGGESTED NIC INTERVENTIONS

Anxiety Reduction; Calming Techniques; Counseling; Health Educa-

tion; Reality Orientation; Truth Telling

Reference

Telford, K., et al. (2006, August). Acceptance and denial. Implications for

people adapting to chronic illness: Literature review. Journal of Advanced
Nursing, 55(4), 457–464.

Nursing diagnosis – IMPAIRED COMFORT

IMPAIRED COMFORT

DEFINITION

Perceived lack of ease, relief, and transcendence in physical, psycho-

spiritual, environmental, and social dimensions

DEFINING CHARACTERISTICS

• Disturbed sleep pattern, inability to relax, and restlessness

• Insufficient resources (e.g., financial, social support)

• Lack of environmental or situational control

• Lack of privacy

• Noxious environmental stimuli

• Reports being uncomfortable, hot or cold, or hungry

• Reports distressing symptoms, anxiety, crying, irritability, and

moaning

• Reports itching

• Reports lack of contentment in situation

• Treatment-related side effects (e.g., medication, radiation)

ASSESSMENT FOCUS

• Cardiac

• Respiratory

• Muscle tone

• Sleep patterns

• Pain

EXPECTED OUTCOMES

The patient will

• Maintain heart rate, rhythm, and respiration rate within expected

range during rest and activity.

• Maintain muscle mass and strength.

• Report pain using pain scale.

• Report periods of restful sleep.

SUGGESTED NOC OUTCOMES

Comfort Status; Coping; Knowledge Health Promotion; Pain Control

INTERVENTIONS AND RATIONALES

Determine: Monitor pain level using scale 1–10. Using a scale will

allow evaluation of the effectiveness of pain-relieving measures.

Assess vitals signs during times of discomfort, including blood

pressure, heart rate and rhythm, and respirations. Use the patient’s

baseline vital signs to evaluate response to pain and response to

pain-relieving measures.

Assess sleeping patterns in response to discomfort. Interruption of

sleep is common in patients experiencing discomfort.

Perform: Provide a quiet and relaxing atmosphere. Encourage active

exercise to increase feeling of well-being. Provide pain medications

as ordered; evaluate response to evaluate effectiveness of pain-relieving

measures.

Inform: Teach relaxation exercises and techniques to promote

reduced pain levels, sleep, and anxiety. Teach medication administra-

tion and schedule to facilitate pain relief. Teach massage therapy to

caregiver to promote comfort.

Attend: Provide support and encouragement during periods of

discomfort. Include patient in plan of action to promote self-care.

Manage: Refer to pain management clinic if pain cannot be

controlled through relaxation and exercise. Refer to physical thera-

pist to accommodate patient’s level of physical activity. Refer to

massage therapist to promote relaxation. All healthcare professionals

contribute to the overall goal of maintaining comfort.

SUGGESTED NIC INTERVENTIONS

Active Listening; Aromatherapy; Calming Technique; and Coping

Enhancement

Reference

Dowd, T., Kolcaba, K., Fashinpaur, D., Steiner, R., Deck, M., & Daugherty, H.

(2007). Comparison of healing touch and coaching on stress and comfort in
young college students. Holistic Nursing Practice, 21(4), 194–202.