Alteration in Comfort Nursing Diagnosis and Care Plans

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Alteration in Comfort Nursing Care Plans Diagnosis and Interventions

Nursing Care Plans Diagnosis and Interventions NCLEX Review Care Plans

Alteration in comfort is a NANDA nursing diagnosis defined as the lack of psychological empowerment, alleviation, and transcendence in the physiological, mental, spiritual, environmental, historical, and social aspects.

Thus, sleeping pattern modification, anxiety attacks, fatigue, and irritability are the defining characteristics of alteration in comfort. In addition, distress, despair, previous surgeries, and comorbidities may contribute to the advancement of sickness and reduce patients’ comfort.

A patient with a history of severe pain, for example, will have a more complex technique in managing pain after surgery than someone who has never had chronic pain from a previous injury. Similarly, a patient with mental illness will receive a unique therapeutic approach than one who does not.

Causes of Alteration in Comfort

Many factors can contribute to alteration in comfort. Some general causes are as follows:

The following are some chronic diseases that might also cause alteration in comfort:

  • Persistent anemia
  • Kidney disorder
  • Heart illnesses
  • Chronic fatigue
  • Diabetes
  • Fibromyalgia
  • Hypertension
  • Kidney disorder
  • Liver diseases
  • Chronic Obstructive Pulmonary Disease (COPD)

Related Factors to Alteration in Comfort

  1. Physical Factors

  • Pain
  • Sleep deprivation
  • Past surgeries
  • Pregnancy
  • Health condition
  • Symptoms of a disease
  1. Emotional Factors

  • Worry
  • Anxiety
  • Depression
  • Insomnia/lack of sleep
  • History of traumas
  1. Environmental Factors

  • Hospitalization
  • Home environment
  • Inadequate environmental control
  • Inadequate privacy
  • Harmful Environmental Stimuli
  1. Other Factors

  • Insufficient knowledge
  • Financial issues
  • Social problems
  • Inadequate situational control

Signs of Alteration in Comfort

Alteration in comfort can differ from person to person. However, here are some of the most prevalent indications and symptoms of discomfort:

  • A pain rating of 3 or higher is considered severe on a pain scale.
  • Reluctance to remain seated in one place.
  • Wanders around the room
  • Nervous breakdown
  • Body protection for the afflicted area
  • Much frowning
  • Breathing quickly and shallowly
  • Anxiety attacks
  • Mood swings and agitation

Diagnosis of Alteration in Comfort

Examine the patient’s physical, mental, emotional, and spiritual elements that may induce alteration in comfort, as well as establish a baseline in each of them

Either of these circumstances could lead to discomfort, especially if the patient is in the hospital. Obtaining a baseline of the patient’s condition is an excellent place to start for healthcare professionals to employ in order to increase the patient’s degree of comfort.

Treatment for Alteration in Comfort

Here are some treatments or management options for reduced comfort:

  1. Make modifications to the environment to increase the patient’s comfort. Environmental alterations tailored to the patient’s preferences may provide him or her with a sense of control and boost comfort. These may include:

  • Using a white noise generator
  • Providing earplugs and an eye mask
  • Reduced external stimuli, such as loud television
  • Reducing the frequency of family visits
  • Changing the lighting in the room
  • Changing the temperature of the room
  1. Provide a variety of stress reduction techniques that may help to alleviate discomfort. The following approaches assist in shifting the focus away from the current pain, worry, and tension and toward more enjoyable sensations:

  • Therapeutic music
  • Exercising breathing techniques
  • Meditation
  • Imagery/visualization with guidance

Alteration in Comfort Nursing Diagnosis

Nursing Care Plan for Alteration in Comfort 1

Pregnancy

Nursing Diagnosis: Alteration in Comfort related to breast tenderness and constipation secondary to pregnancy as evidenced by breast pain and slow peristalsis.

Desired Outcome: The patient will be able to ease the breast tenderness and will be able to have a regular bowel movement.

Nursing Interventions for Alteration in ComfortRationale
Advise the patient to use a type of bra with a broad shoulder strap.  As the bra supports the breast, this approach will assist the patient in relieving the tenderness and discomfort.
Instruct the patient to dress warmly and turn down the cold temperature in the room.  Since exposure to cold enhances breast soreness, the patient should dress appropriately. The blood vessels constrict more in cold temperatures. Therefore, it contributes to breast pain.
If the breast tenderness persists and the pain becomes intolerable, advise the patient to seek medical help and get examined as soon as possible.To rule out nipple fissures or breast abscesses, women experiencing severe and persistent pain should have their breasts examined.  
Instruct the patient about the implications of iron supplements.Advise the patient that iron supplements can lead to constipation but should not be discontinued because they help build fetal iron reserves. Educate the patient to take iron after meals or use it with a stool softener to reduce constipation.  
Educate the patient to consume more water or fluids and increase fiber intake.Even though fiber and plenty of fluids are beneficial to the healthy digestion of all men, women, and children, getting enough fiber and water becomes more critical during pregnancy. Many expectant women will undergo constipation due to the hormone-slowed digestive system and organ-displacing womb. That is why this technique will help prevent constipation.

Nursing Care Plan for Alteration in Comfort 2

Pain due to Surgery

Nursing Diagnosis: Alteration in Comfort related to physical injury secondary to postoperative pain as evidenced by uneasy and tense feeling in the affected area.

Desired Outcome: The patient will understand the techniques to deal with any type and severity of pain.

Nursing Interventions for Alteration in Comfort Rationale
Advise the patient to take analgesics.By stimulating the thalamic and cerebral cortex function, analgesics can interfere with the transmission and processing of pain stimuli. This method should be considered if the patient’s pain is intolerable and cannot be managed by non-pharmacological treatments.  
Examine and record the patient’s pain characteristics:
-Quality of pain (e.g., sharp, burning)
-Intensity (scale of 0 to 10)
-The area of pain (anatomical description)
-Examine whether the pain is gradual or sudden onset
-Timeframe (e.g., continuous, intermittent)
-Triggers or Related factors  
The most accurate information source about severe pain is the patient’s report. That is why it is one of the most important interventions of pain.
Assess the patient’s capacity to execute and accomplish activities of daily living (ADLs), instrumental activities of daily living (IADLs), and daily living needs (DDLs).Fatigue, worry, and despair associated with chronic pain might impede a person’s capacity to undertake self-care chores and perform role obligations.
Examine the patient’s pain-relief perceptions and beliefs.  Patients suffering from chronic pain may not expect perfect pain relief but may be content with a reduction in pain intensity and an increase in the level of physical activity.
Consider cultural, socioeconomic, and religious issues that may impact the patient’s pain perspective and response to pain alleviation.  Understanding the factor that affects the patient’s pain condition can help design a patient-acceptable care plan.  

Nursing Care Plan for Alteration in Comfort 3

Anxiety

Nursing Diagnosis: Alteration in Comfort related to excessive and intense fear secondary to anxiety disorder as evidenced by restlessness and nervousness.

Desired outcome: The patient will be ably knowledgeable on coping with anxiety.

Nursing Interventions for Alteration in Comfort Rationale
As needed, acquaint the patient with the surroundings and unique experiences or individuals.Being aware of the surroundings enhances comfort and may reduce the patient’s worry. Anxiety can become panic-like if the patient feels threatened and unable to manage external stimuli.  
Reduce sensory inputs by maintaining a serene and quiet environment; keep “provoking” equipment out of eyesight.  Prolonged discussion, commotion, and equipment near the patient might cause anxiety to escalate to a panic episode. Anxiety may be distressing for both the patient and others. That is why keeping a quiet environment provides comfort to the patient.  
Support the patient in learning new anxiety-reduction techniques (e.g., reassuring self-statements, deep breathing exercises, positive visualization, and relaxation).This technique will improve the patient’s discomfort. Discovering new coping skills gives the patient several options for dealing with anxiety.    
Counsel the patient on how to take antianxiety drugs properly.When used for a short period, Antianxiety drugs can improve patient tolerance, lessen physiological signs of anxiety, and provide comfort.
Educate the patient to picture or imagine the absence of anxiety or pain, a pleasurable experience of the scenario, conflict resolution, or the operation outcome.The use of guided visualization has been shown to lower anxiety and alleviate discomfort.  

Nursing Care Plan for Alteration in Comfort 4

Chronic Obstructive Pulmonary Disease (COPD)

Nursing Diagnosis: Alteration in Comfort related to ineffective breathing patterns secondary to COPD as evidenced by crackles or wheezes on auscultation of both lungs.

Desired outcome: The patient will learn how to enhance respiratory rhythm and how to keep the breathing rate within a reasonable range.

Nursing Interventions for Alteration in Comfort Rationale
Help the patient find a comfortable posture; Uplift the head of the bed, have the patient recline on an overbed table or lean on the side of the bed.Lifting the head of the bed promotes pulmonary function using gravity; yet, a patient in acute discomfort will seek the position that most comfortably allows them to breathe. Supporting the arms and legs with a table, pillows, or other items reduces muscle soreness and can help with chest expansion.  
Allow for periods of uninterrupted sleep by providing a calm environment, group care, or monitoring activities, limiting stimulants such as caffeine, and encouraging comfort positions.This method provides comfort for the patient since numerous external factors and dyspnea may hinder relaxation and sleep.  
Educate the patient on how to support the chest wall with a pillow for comfort during coughing and how to elevate the head above the body as needed.This approach encourages the physiological ease of maximum inspiration.  
Educate the patient to raise fluid intake (2.5 liters or more per day) as directed.This approach will provide comfort to the patient despite the patient’s continual coughing since fluids aid in lowering the thickness of discharges in patients with chronic high sputum output.  
Evaluate specific circumstances that may cause or worsen the disease (dry air, air pollution, wind, pollen, environmental temperature extremes, aerosol sprays, tobacco smoke). Encourage the patient and look into measures to control these issues at work and home.  These environmental elements can cause or worsen bronchial irritation, resulting in increased secretion production and airway obstruction. As a result, reducing the triggers will reduce the patient’s discomfort.  

Nursing Care Plan for Alteration in Comfort 5

Heart Failure

Nursing Diagnosis: Alteration in Comfort related to decreased cardiac output secondary to congestive heart failure as evidenced by elevated heart rate (tachycardia), irregular heartbeats (dysrhythmias), and abnormalities in the electrocardiogram (ECG)

Nursing Stat Facts 1
Nursing Stat Facts 1

Desired Outcome: The patient will have adequate cardiac output as shown by vital signs within reasonable parameters, dysrhythmias will be controlled, and no indicators of heart failure (e.g., hemodynamic parameters within allowable limits and adequate urinary output.)

Nursing Interventions for Alteration in Comfort Rationale
Create a comfortable environment for the patient, promote relaxation and sleep, and assist with tasks.Controllable stressors and unnecessary disturbances are reduced in cardiac effort and oxygen consumption. Rest, both physical and emotional, enables patients to conserve energy. Thus, the intensity of the Heart Failure determines the amount of rest required. Patients with severe heart failure may need to rest in bed, but those with mild to moderate heart failure can be ambulatory with minimal exercise.
Every two (2) hours, reposition the patient.Extended immobility should be prevented for bedridden patients due to deconditioning effects and risks such as pressure ulcerations, particularly in patients with edema. In inflamed areas, diminished circulation increases the chance of pressure sores.
Provide oxygen based on the patient’s condition, oxygen levels, and arterial blood gasses (ABGs).Oxygen therapy improves myocardial oxygen availability and can help reduce symptoms of hypoxemia, infarction, and consequent activity intolerance. The degree of lung congestion and consequent hypoxia determines the necessity. Continuous pulse oximetry assesses the requirement for and efficacy of oxygen replenishment    
Rest in a semi-recumbent position in bed or a chair. As needed, assist with physical care.Physical relaxation should be sustained during acute or refractory heart failure to increase myocardial contraction efficiency and decrease increased cardiac demand or consumption and exertion. Thus, enforce total bed rest when feasible to reduce the heart workload during acute symptomatic heart failure attacks.
Provide a relaxed atmosphere for the patient; Explain treatment, assist the patient in avoiding stressful situations, and not respond to negative emotions.  Mental relaxation aids in the reduction of emotional stress, which can cause vascular constriction, an increase in blood pressure, and an increase in heart rate. Therefore, this method will diminish the discomfort brought about by the condition.  

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

Disclaimer:

Please follow your facilities guidelines, policies, and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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