Impaired Comfort Nursing Diagnosis and Care Plan

Impaired Comfort Nursing Care Plans Diagnosis and Interventions

Impaired Comfort NCLEX Review and Nursing Care Plans

Impaired Comfort is a NANDA nursing diagnosis referred to as an apparent lack of solace, relief, and enlightenment of an individual’s physiological, psycho-spiritual, environmental, intellectual, and social patterns.

In the most extensive context, patients’ responses and perspectives in oncology palliative care are also expected to align with this concept. However, even the most substantial perceptions are inadequate for diagnosing purposes, and remains a constant endeavor to validate the diagnosis.

Furthermore, disrupted sleep patterns, panic attacks, fatigue, and irritability are all symptoms of impaired Comfort. Anguish, desperation, preceding invasive procedures, and chronic health conditions may also contribute to the pathogenesis of illness and ultimately reduce comfort.

Thus, a patient who has suffered severe painful symptoms, for example, will require a stronger technique to manage pain after surgery than someone who has never struggled with chronic pain from any previous injury. Patients suffering from mental illnesses will also benefit from a promising pharmacological approach.

Causes of Impaired Comfort

Many factors can influence changes in comfort. The following are some general causes:

  • Overburden or Stressful situations
  • Impaired mental health conditions
  • Long-term or severe health issues
  • Older age
  • Lethargy
  • Strictly limited physical activities or workout
  • Pregnancy or Miscarriage
  • Bacterial or viral infection
  • Sudden withdrawal from using drugs or alcohol
  • Medications that cause Malaise as an adverse effect

The following are a few chronic diseases that can also have an impact on comfort:

  1. Physical factors

Discomfort or pain brought by a particular health condition

  • Lack of enough sleep and rest
  • Previous surgical or invasive procedures
  • Gestation
  • Comorbidities
  • Severe overall health issues

2. Emotional factors

  • Fear
  • Anxiousness
  • Distress
  • Sleep insufficiency or Insomnia
  • History of traumatic experiences

3. Environmental considerations

  • Hospitalization
  • Atmosphere at home
  • Poor environmental management
  • Insufficient confidentiality
  • Devastating environmental stimuli

4. Other considerations:

  • Lack of financial support (e.g., financial, social, knowledge)
  • Unsatisfactory situational awareness

Nursing Management of Impaired Comfort

  1. Determine a reference point for each of the factors that may cause discomfort.
  • Physiological
  • Emotional
  • Social-economic
  • Spiritual

Any of these elements could cause impaired comfort, especially if the patient is in the hospital. Obtaining a reference point of the patient’s situation is an ideal starting point for health practitioners to use in order to enhance the patient’s degree of comfort.

  1. Evaluate ineffective communication. Communication barriers, physical impairments, and other factors such as mistrust or shame can make it difficult for patients to communicate their fears and emotions.
  1. Determine the patient’s level of pain. To evaluate pain levels, use accurate pain scales. Pain may be regarded as a form of impaired comfort that must be acknowledged. During this evaluation, it is possible to determine what degree of suffering is tolerable for the patient and a target level of pain treatment.
  1. Collect a comprehensive history of the factors that may influence the patient’s comfortability and assess how well these factors may affect the patient’s comfort during the healing process. Thus, nervousness, distress, previous invasive procedures, and comorbidities may contribute to existing illness and minimize patient comfort. A patient with a history of severe pain, for example, will have a more intricate approach to pain management after surgery than someone who has never had chronic pain from a previous injury. Similarly, a patient who suffers from depression will receive a unique treatment regimen than one who does not.
  1. Examine the patient’s coping methods of dealing with impaired comfort. Coping mechanisms that have proven successful in the past may no longer be effective. This evaluation is also required so that healthcare professionals can provide the patient with the latest coping strategies.
  1. Make changes to the environment to improve the patient’s comfort.
  • Using a noise cancellation generator
  • Reduction of environmental stimuli, such as loud television
  • Changing the illumination
  • Limiting the frequency of family visits
  • Providing earbuds and an eye mask
  • Changing the temperature of the room
  1. Provide a variety of mindfulness meditation that may help to mitigate impaired discomfort.

  • Imagery or visualization with supervision
  • Appropriate deep breathing techniques
  • Contemplation
  • Therapeutical songs
  1. Administer pain relievers as directed. Pain, if not the origin of the patient’s discomfort, can be an additional source of stress to the already emerging discomfort, exacerbating the patient’s condition.
  1. As a nonpharmacological pain treatment option, provide heat or cold application. If a patient is hot or cold, heating blankets and ice packs can be used as advanced equipment to relieve pain or promote recovery
  1. Reposition the patient regularly and motivate range-of-motion activities. Modifications in the patient’s position ameliorate stress and tension and aid in pain control. Furthermore, initial treatment may alleviate the discomfort associated with bed rest.
  1. Modifications in the patient’s position ameliorate stress and tension and aid in pain control. Furthermore, initial treatment may alleviate the discomfort associated with bed rest.
  1. If the patient does not endure other forms of stimulation, such as back massage, consider healing touch. For instance, healing touch is a type of complementary therapy based on the idea that the sense of touch lessens cortisol levels in the body. Cortisol is a stress hormone that stimulates blood pressure, blood sugar levels, and heart rate. As a result, healing touch may help reduce stress and anxiety.
  1. Determine what factors can help the patients alleviate discomfort. Ask the patient if they have done anything to ameliorate their impaired comfort. Contemplation, breathing exercises, praying, and other similar practices may be included. Information on these discomfort-relieving activities can be incorporated into management planning.
  1. Focus on providing discomfort-relief measures before they become drastic. It is beneficial to administer an analgesic prior to starting pain or before it becomes serious, as a higher dose may be required. Preemptive analgesia, the administration of analgesics prior to surgery to reduce or relieve pain after surgery, is one example. Preventive measures are also beneficial prior to painful procedures such as wound dressing changes, physical therapy, and postural drainage.
  1. Recognize and accept the patient’s pain. Nurses have a responsibility to ask their patients about their pain and to believe their patients’ reports of pain. Therefore, challenging or undermining their pain reports leads to an unhealthy therapeutic relationship, impeding pain management and deteriorating rapport.

Impaired Comfort Nursing Diagnosis

Impaired Comfort Nursing Care Plan 1

Labor and Delivery

Nursing Diagnosis: Impaired Comfort related to constricted blood vessels due to contractions and diminished blood supply to uterine and cervical cells, which results in muscle fiber anoxia secondary to labor and delivery as evidenced by ischemia to the cells and intense pain.

Desired Outcome: The patient will learn to manage intense pain during labor and delivery.

Nursing Interventions for Impaired ComfortRationale
Educate the patient about different ways to relax during labor and delivery.  Relaxing prevents the abdominal wall from becoming tense and allows the uterus to rise without pressing against the abdominal wall during contractions.
Advise the patient to find her most comfortable position during labor, as this will greatly assist her in relaxing.    As the patient finds a comfortable position, it will also serve as a distraction technique because it takes her mind off the pain she is experiencing.
Advise the patient to choose an object to focus on that will distract her, especially during labor.    Concentrating on a specific object also prevents sensory input from reaching the brain’s cortex, thereby avoiding pain.    
Avoid disturbing the patient by asking unnecessary questions while she is trying to shift her focus.  This method will allow the patient to focus on her concentration. Allow her to divert her attention to relieve the intense pain brought by labor.  
If applicable to the patient’s religion or belief, advise them to divert their attention through praying or listening to worship songs.  This intervention is beneficial for patients who find comfort from prayers during stressful life situations.  
Teach the patient about different breathing techniques.  Breathing techniques can help a woman’s abdomen relax during contractions. It can also be regarded as a distraction approach because the patient focuses on slow-paced breathing rather than the pain. Furthermore, breathing techniques are best taught to the patient prior to labor, but if she is unfamiliar with them, she can still be coached while in labor.
Inform the patient that they may opt to take herbal supplements that can help with labor pain. Ensure that these are approved by the patient’s doctor.  Raspberry leaves, fennel, and life root are common herbal supplements used to ease labor pain.
Utilize heat or cold application to patients to provide comfort.  Heat application to the patient’s lower back experiencing pain during labor will be soothing. On the other hand, after labor, cool cloth to the forehead may help to relieve the woman’s exhaustion. While during labor, ice chips can also help relieve a woman’s mouth’s dryness.  
Therapeutic touch and massage are also effective ways to improve the alteration in the patient’s comfort.  Through the laying of hands, therapeutic touch redirects the energy fields that cause pain. As a result, when touch or massage is applied, the release of endorphins increases, resulting in a reduction in pain. Furthermore, Effleurage is a type of therapeutic touch taught in Lamaze classes that is particularly beneficial during the first and second stages of labor.    

Impaired Comfort Nursing Care Plan 2

Hernia

Nursing Diagnosis: Impaired Comfort related to obstruction of the intestine and surgical repair secondary to hernia as evidenced by acute pain, inflammation in the umbilical area, and irritability.

Desired Outcome: With the use of a pain scale, the patient will be able to express feelings of comfort and reduce the pain.

Nursing Interventions for Impaired ComfortRationale
Examine the incision pain of the patient and nonverbal pain indicators such as crying, extreme fatigue, and a grimace on the face.  This approach determines the need for analgesic therapy to be started.
Administer analgesics depending on the severity of the pain and the patient’s age.  Pain and discomfort caused by the incision are relieved with this intervention.
Maintain the patient’s comfortable positionThis technique improves comfort and reduces painful symptoms by the strain on the incision.
If the hydrocele has been rectified, apply an ice compress to the scrotal area and, if necessary, provide scrotal support.  This approach reduces swelling and thus promotes comfort.    
Support the buttocks of the patient when trying to lift heavy objects or when changing positions.Avoid putting strain or pulling on the incision site.
Encourage parents to change patient’s diapers regularly.Wet diapers cause irritation and pain at the incision site.
Toys and games for quiet play should be available.This method allows for a diversionary activity to distract the patient from pain.
Instruct parents to hold the infant during feedings and allow them to burp frequently to remove ingested air if the infant is grumpy.  This approach relieves strain on the incision and increases comfort.
Teach the parents about the types of pain and the available treatments to alleviate it.  This intervention gives a better understanding of postoperative pain treatments.    
Evaluate for any swelling in the umbilical or inguinal area while the infant whines or when the child strains or coughs, as well as the potential to eliminate swelling with soothing compression if the bowel is forced into the sac.  This intervention demonstrates a reducible hernia, which means it is easily swayed back into position.  
Instruct the parents to inform the physician of any signs and symptoms immediately; notify them of the reason for the disorder and the expected effect, as well as those that indicate an interference.This intervention precludes a more severe complication of bowel gangrene.    
Educate the parents about the surgical procedure for repairing hernias, possible hydroceles, and predicted development.    If a hernia or hydrocele is present prior to developing a complication, this intervention rectifies and repairs it.
Assure parents that a hernia usually heals on its own and that if it does not, surgery is an option.    This intervention provides comprehension of the disorder’s prognosis.
Examine the hernia site for tenderness and other symptoms such as increased abdominal girth, lack of appetite, lethargy, and alteration in defecation.    As a result of incarceration and strangulation, this intervention reveals partial or complete obstruction.
To avoid straining, inform the parents on nutritional inclusions and limitations.    Dietary modifications are beneficial to preclude digestive problems, reduce straining, and improve intra abdominal pressure to prevent forcing the bowel into the sac.

Impaired Comfort Nursing Care Plan 3

Dying Child

Nursing Diagnosis: Impaired Comfort related to acute anxiety, anticipatory loss, and dysfunctional bereavement secondary to imminent death of the child as evidenced by inconsolable crying and verbal report of discomfort and/or pain.

Desired Outcome: The child, parents, and family will be able to express their despair in a culturally appropriate way.

Nursing Interventions for Impaired ComfortRationale
Evaluate the stage of the grieving process, the obstacles faced, and feelings about the terminal nature of the disease and the possible loss of the child.  When a child’s death is imminent, this intervention explains why individual family members need to grieve differently.    
Motivate parents and family members to spend more time as they feel they need with the child, and help them acknowledge the child’s behavior and needs.  This intervention encourages the feeling that they are assisting and supporting their child.    
Allow the family to talk about their feelings and respond to the child based on their stage of grieving.  This intervention encourages progression through grief and the ability to express desires for oneself and one’s child.    
Offer additional spiritual and emotional guidance in a safe environment, and restrict conversations that promote remorse or frustration.  This intervention provides emotional support to parents and relatives, assisting them in adjusting to the child’s death without adding stress factors that are challenging to resolve.    Make use of therapeutic communication techniques like active listening. Encourage parents to express their understanding of the underlying causes of death, their thoughts of sadness, and any worries about grief counseling.  The use of therapeutic communication allows the parents to control their feelings and recognize the dysfunctional factors of their grief.    
Encourage expressions of worries and questions about the end phase of the disease, and address questions truthfully based on what the family has been told about the prognosis.    This intervention allows patients to express their emotions and concerns to lessen anxiety.
Allow a family member to stay with the child during stressful times when the parents are not present.  This intervention promotes child solace and supports all through anxious and fearful times.
Assist the child and family in identifying at least two coping mechanisms for anxiety: humor, breathing exercises, contemplation, relaxation, workout, chatting to a spiritual director, and engaging in enjoyable experiences.    Anxiety stress can be reduced by using coping skills. Humor is not always inappropriate and, when used wisely, can help to reduce tension.
Inform the child and his or her parents of all the planned care programs and activities.      Encourages understanding of the physiological needs of a terminally ill child and severely limits activities to those that are essential.
Include the child and parents planning of the care regimen as possible.    This intervention nurtures interactions and compassion within the family.
Allow the parents to communicate with their children and lie down near them as preferred.    This intervention decreases the possibility of extra burden for the child. It also reduces the child’s worries about being alone.
Assure the child and parents that they are not to blame for the illness or its implications.  This approach alleviates the guilt and fear caused by the terminal nature of the disease.  

Impaired Comfort Nursing Care Plan 4

Hypospadias

Nursing Diagnosis: Impaired Comfort related to acute pain and urinary excretion deficiencies secondary to hypospadias as evidenced by spasms in the bladder, dysuria, painful urination, and diminished urine output.

Desired Outcome: The patient’s urinary elimination will improve, and he or she will feel less pain.

Nursing Interventions for Impaired ComfortRationale
Monitor the input and output of the patient. Evaluate the voiding stream, appearance, and urine volume on the first void and each successive void.    This intervention provides information on the voiding pattern after catheter clamping or removal.
For the next 8 hours, inspect for pain, abdominal discomfort, and limited urination capacity.  This approach suggests urinary impairment and possible blockage or ongoing meatus edema.    
Instruct the patient to have high fluid intake after catheter removal and provide preferred liquids hourly.      This approach maintains hydration and free urine flow.
After the catheter has been removed, provide the child with privacy to urinate.  This method saves an older child from humiliation.    
Advise parents to immediately inform the physician if their child’s urinary pattern changes or if he or she is unable to urinate.    This approach allows for early treatment in order to prevent further health problems.
Examine the pain’s site, attributes, emergence, duration, recurrence, and intensity. Look for verbal and nonverbal cues as well.    This method provides information about pain characterizations that can be used as a guideline for analgesic therapeutic interventions.
Maintain a comfortable position; Arranged the catheter properly to avoid strain and twisting.    It provides comfort and prevents pain caused by pulling on or controlling the catheter.
Encourage the patient to use mindfulness techniques.  This approach reduces discomfort by encouraging rest and refocusing attention.    
Apply the ice compress as instructed.      This intervention serves as pain relief and causes edema reduction.    
As directed, prescribe analgesics.    Analgesics reduce pain and promote rest, minimizing triggers and pain.    
Teach the parents how medications can help them avoid pain and restlessness while healing.This intervention provides information on the need for pain medications to comfort patients.        

Impaired Comfort Nursing Care Plan 5

Puerperal Infection

Nursing Stat Facts
Nursing Stat Facts

Nursing Diagnosis: Impaired Comfort related to infection, imbalanced nutrition, and a possible danger to one’s survival secondary to puerperal infection as evidenced by anxiety, damaged skin or traumatized tissues, weight loss, and transmission of the disease.

Desired Outcome: These interventions aim to control the transmission of infection, enhance recovery, and strengthen the parent-infant connection.

Nursing Interventions for Impaired ComfortRationale
Examine the prenatal, intrapartum, and postpartum records.  This intervention distinguishes risk factors for the development/spread of postpartum infectious disease in the patient.
Establish and enforce a strict hand-washing strategy for staff, patients, and visitors.This approach assists in preventing cross-contamination.
Educate the patient on correctly disposing of dirty linens, dressings, and periods. If necessary, maintain isolation.This technique inhibits the transmission of infection.    
Demonstrate proper perineal cleanup after voiding and defecation, as well as frequent peripad replacement.Cleaning eliminates urinary and fecal contaminants. The changing pad removes the moist medium, which promotes bacterial growth.    
Demonstrate proper fundal massage to the patient. Explain the procedure’s significance and timeframe.  This method increases uterine contractility and promotes the involution and passage of any retained placental fragments.    
Talk about the eating habits, including food preferences and intolerances of the patient.  This intervention aims to encourage the patient of what she likes or desires.  
Remain aware of total daily intake. Keep a diary of the calorie intake, eating patterns, and eating intervals.  This approach aims to identify diet recommendations that should be made for the patient.
Encourage the consumption of at least two thousand mL of beverages, soups, and other nutrient-dense fluids each day.  Calories and other essential minerals are provided to satisfy metabolic requirements, and fluid losses are replaced, raising the circulating fluid volume.    
When oral consumption is allowed, encourage the intake of a good source of protein, iron, and vitamin C.  Protein aids in the restoration and healing of new tissue, while the iron is required for Hb biosynthetic pathways. Thus, vitamin C aids metabolism and is required for cell wall synthesis.    
Encourage sufficient sleep and rest.      Having enough rest and sleep lowers metabolic rate and allows nutrients and oxygen to heal.
Keep track of the patient’s emotional reactions to ailment and detachment from the infant, such as anger and depression. Encourage the patient to express his or her thoughts and emotions and, as necessary, strengthen normalcy.  Normal expectations are for a specific postpartum period with the family unit intact. Illness caused by infection changes the situation and may result in the patient being separated from his or her family or newborn, which can contribute to feelings of loneliness and distress.    
Examine maternal-infant relationships.  This intervention provides data on the progress of the bonding process and patient requirements.
Whenever applicable, provide opportunities for maternal-infant contact. Place pictures of the infant by the patient’s bed mainly if the nature of the infection or patient’s condition or hospital policy necessitates isolation of the infant from the mother during the febrile period.  Aids attachment by preventing the patient from becoming preoccupied with himself to the exclusion of the infant.    
Encourage the father or other family members to communicate with and care for the infant.  It may be reassuring to the mother to know that her family cares for her infant and offers emotional support. Note: An unexpected/prolonged hospital stay may limit the father’s ability to spend time with the newborn due to other responsibilities, such as caring for siblings. During this stressful period, the father may require additional assistance.    
Discuss the accessibility and effectiveness of support systems in the home.    The client needs additional assistance to complete homemaker tasks, allowing the patient to rest and spend quality time with the newborn baby and other children.    
Determine personal support networks. Refer to the indicated visiting nurse services and home care organizations.    While following discharge instructions for rest and recuperation, the patient may seek support with home maintenance and daily living activities.
Encourage the continuation of breastfeeding as long as the patient’s condition allows. Alternatively, recommend and advise on using a manual or electric breast pump.  Precludes engorgement discomfort and fosters adequate milk production in breastfeeding mothers.    

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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