04~舒适与安全.ppt
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Chapter10
Comfort and safety
Objectives
* 1. Describe " Comfort, pain"
* 2. Identify the etiologies causing discomfort
* 3. Describe the nursing care of clients with
* pain
* 4. Understand the functions of common
* positions.
* 5. Know the usages of protective devices,* crutches and canes.
Section 1
To Meet Comfort Need
* 1. Comfort: strengthen greatly, renewal
? *(1) Definition：a mental state of physical
?and psychological health,no pain no anxiety and relaxing at ease.
subjective feeling, a positive mind-set
client-led&nurse-controlled
* (2) Highest level of comfort:
all need are met
* (3) Related factors
aPhysical comfort needs
bPsychospiritual comfort needs
cSocial comfort needs
dEnvironmental comfort needs
* 2. Discomfort
* (1) Etiology
* *(2) Manifestation
*irritation
*insomnia
*fatigue
depress
loss
despair
pain
* (3) Nursing
* A solace: talking in soothing tones
* B providing a warm blanket a cup of tea
* C maintaining a quiet environment
* D coordinating the activities of other staff
* E supporting: medical staff. the clients family
*members or significant others
* F touch, applying lotion to dry skin
* G encouraging decision making
* 3 The methods to improve comfort
* Position
Active Position
passive Position
Compulsory Position
Stable Position
Unstable Position
*Position
* asupine position: dorsal recumbent P
* bside lying position: lateral P
* cFowler's position: Semisitting P
* dorthopneic position
* eprone position
* f trendelenburg position
* gdorsal elevated position
* hknee chest position
* i lithotomy position
Section 2Pain
* **1. Definition
* An unpleasant sensory and emotional experience associated with actual or potential damage or described in terms of such damage.
* * 2. Nature
* Physiologic and psychologic
* subjective and individual
* body's defense mechanisms
* 3. Types of pain
* (1) According to its origin
a Cutaneous pain：skin, subcutaneous
b Deep somatic pain: ligament, bone, nerves
c Visceral pain: abdominal cavity, cranium
*(2) According to where it is experienced in the body
a Radiating pain
b Referred pain
* C According to duration
a acute pain
b chronic pain
* D Intractable pain
* E Neuropathic pain
* F Phantom pain
* G Pain syndromes
* 4 Precipitating factors
* achemical factors:
* bPhysical factors: temperature, incision,* cpathological factors: diseases
* d. Emotional factors:
* 5 Concepts associated with pain
* pain threshold is the amount of pain stimulation a person requires in order to feel pain
* pain tolerance is the maximum amount and duration of pain that an individual is willing to endure
* 6 Factors affecting the pain experience
* a Ethnic and cultural values
* b Developmental stage
* c Past pain experiences
* d Attention
* e Emotion:Anxiety and stress
* F Individual difference
* G Social support system
* H Medical staff
7 NURSING
* (1) ASSESSING
* A Pain history
* B Effect on activities of daily living
* C Sounds and posture
* D Coping resources
* E Intensity, quality and location
*Grade (score)
* 0 :no pain
* 1 :mild pain ,can tolerance ,do not disturb sleep
* 2: moderate pain ,can not tolerance , disturb
* sleep ,need drug
* 3: severe pain , can not tolerance , disturb sleep
* seriously ,need drug
* * Measure Methods
*a Numerical rating scales
*b Verbal descriptors scales
*c Visual analogue scales
DIAGNOSING
* Ineffective airway clearance
* Anxiety
* Ineffective individual coping
* Altered health maintenance
* Knowledge deficit
* Impaired physical mobility
* Sleep pattern disturbance
**IMPLEMENTING
* 1) pain management
* A pharmacologic
* First stage
NSAIDs (non steroid anti-inflammatory drugs)
Nonopioids (nonarcotic) analgesics
Antipyretic
* Second stage
Opioid analgesics (codeine)
* Third stage
Opioid analgesics (dolantin morphine)
* Assistant drug
Valli
B nonpharmacologic (physical)
a Heat and cold application
b TENS (transcutaneous electrical nerve stimulation)
c massage acupressure
* C acupuncture
* D immobilization
* 2 psychological nursing
a reduce mental pressure
**b distraction
* distraction activities (playing, watching
TV, singing, enjoying music)
* relaxation technique
* imagery
EVALUATING
* therapeutic touch
* hypnosis
* bio-feedback
* meditation
* Message
3 promote comfort
Section 3Safety
1 Factors affecting safety
* mechanical injury
* physical injury
* chemical injury
* biological injury
* nosocomial injury
2 Device to prevent injury
A. protective devices
bedside rail restraints
safety strap body restraints
overbed cradle
B. assistant devices
crutches
canes
Chapter10
Comfort and safety
Objectives
* 1. Describe " Comfort, pain"
* 2. Identify the etiologies causing discomfort
* 3. Describe the nursing care of clients with
* pain
* 4. Understand the functions of common
* positions.
* 5. Know the usages of protective devices,* crutches and canes.
Section 1
To Meet Comfort Need
* 1. Comfort: strengthen greatly, renewal
? *(1) Definition：a mental state of physical
?and psychological health,no pain no anxiety and relaxing at ease.
subjective feeling, a positive mind-set
client-led&nurse-controlled
* (2) Highest level of comfort:
all need are met
* (3) Related factors
aPhysical comfort needs
bPsychospiritual comfort needs
cSocial comfort needs
dEnvironmental comfort needs
* 2. Discomfort
* (1) Etiology
* *(2) Manifestation
*irritation
*insomnia
*fatigue
depress
loss
despair
pain
* (3) Nursing
* A solace: talking in soothing tones
* B providing a warm blanket a cup of tea
* C maintaining a quiet environment
* D coordinating the activities of other staff
* E supporting: medical staff. the clients family
*members or significant others
* F touch, applying lotion to dry skin
* G encouraging decision making
* 3 The methods to improve comfort
* Position
Active Position
passive Position
Compulsory Position
Stable Position
Unstable Position
*Position
* asupine position: dorsal recumbent P
* bside lying position: lateral P
* cFowler's position: Semisitting P
* dorthopneic position
* eprone position
* f trendelenburg position
* gdorsal elevated position
* hknee chest position
* i lithotomy position
Section 2Pain
* **1. Definition
* An unpleasant sensory and emotional experience associated with actual or potential damage or described in terms of such damage.
* * 2. Nature
* Physiologic and psychologic
* subjective and individual
* body's defense mechanisms
* 3. Types of pain
* (1) According to its origin
a Cutaneous pain：skin, subcutaneous
b Deep somatic pain: ligament, bone, nerves
c Visceral pain: abdominal cavity, cranium
*(2) According to where it is experienced in the body
a Radiating pain
b Referred pain
* C According to duration
a acute pain
b chronic pain
* D Intractable pain
* E Neuropathic pain
* F Phantom pain
* G Pain syndromes
* 4 Precipitating factors
* achemical factors:
* bPhysical factors: temperature, incision,* cpathological factors: diseases
* d. Emotional factors:
* 5 Concepts associated with pain
* pain threshold is the amount of pain stimulation a person requires in order to feel pain
* pain tolerance is the maximum amount and duration of pain that an individual is willing to endure
* 6 Factors affecting the pain experience
* a Ethnic and cultural values
* b Developmental stage
* c Past pain experiences
* d Attention
* e Emotion:Anxiety and stress
* F Individual difference
* G Social support system
* H Medical staff
7 NURSING
* (1) ASSESSING
* A Pain history
* B Effect on activities of daily living
* C Sounds and posture
* D Coping resources
* E Intensity, quality and location
*Grade (score)
* 0 :no pain
* 1 :mild pain ,can tolerance ,do not disturb sleep
* 2: moderate pain ,can not tolerance , disturb
* sleep ,need drug
* 3: severe pain , can not tolerance , disturb sleep
* seriously ,need drug
* * Measure Methods
*a Numerical rating scales
*b Verbal descriptors scales
*c Visual analogue scales
DIAGNOSING
* Ineffective airway clearance
* Anxiety
* Ineffective individual coping
* Altered health maintenance
* Knowledge deficit
* Impaired physical mobility
* Sleep pattern disturbance
**IMPLEMENTING
* 1) pain management
* A pharmacologic
* First stage
NSAIDs (non steroid anti-inflammatory drugs)
Nonopioids (nonarcotic) analgesics
Antipyretic
* Second stage
Opioid analgesics (codeine)
* Third stage
Opioid analgesics (dolantin morphine)
* Assistant drug
Valli
B nonpharmacologic (physical)
a Heat and cold application
b TENS (transcutaneous electrical nerve stimulation)
c massage acupressure
* C acupuncture
* D immobilization
* 2 psychological nursing
a reduce mental pressure
**b distraction
* distraction activities (playing, watching
TV, singing, enjoying music)
* relaxation technique
* imagery
EVALUATING
* therapeutic touch
* hypnosis
* bio-feedback
* meditation
* Message
3 promote comfort
Section 3Safety
1 Factors affecting safety
* mechanical injury
* physical injury
* chemical injury
* biological injury
* nosocomial injury
2 Device to prevent injury
A. protective devices
bedside rail restraints
safety strap body restraints
overbed cradle
B. assistant devices
crutches
canes
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