Impaired Comfort Nursing Diagnosis & Care Plan


The words impaired comfort surrounded by healthcare-related vector images

Related Factors

  • Physical discomfort
    • Pain 
    • Lack of sleep 
    • Surgery 
    • Medical equipment 
  • Mental discomfort
    • Worry 
    • Anxiety 
    • Lack of sleep/ Insomnia 
  • Environmental
    • Hospitalization 
  • Spiritual discomfort 

Subjective Data: patient’s feelings, perceptions, and concerns. (Symptoms)

  • Verbalizes pain either on a specific area of the body or generalized 
  • Verbalizes feeling of tiredness and exhaustion 
  • Expresses concern about health condition, procedure 
  • States a sense of unease about financial/ social support 

Objective Data: assessment, diagnostic tests, and lab values. (Signs)

  • Rates pain above 3 on a pain scale 
  • Inability to sit still in one place 
  • Roams around the room 
  • Crying/moaning 
  • Guarding of the affected area of the body 
  • Frequent grimacing 
  • Fast, shallow breathing 
  • Anxiety episodes 
  • Irritability/ restlessness

Expected Outcome 

  • The patient will verbalize a pain score of less than 3 on a pain scale
  • The patient will demonstrate how to use coping mechanisms when in distress 
  • The patient will verbalize a feeling of improved comfort 
  • The patient will be able to maintain a desired level of comfort 

Nursing Assessment 

Assess several factors that may cause discomfort and obtain a baseline in each of them. 

Physical 
Mental 
Socioeconomic 
Spiritual 

Any of these factors may cause discomfort, especially during hospitalization. Obtaining a baseline of the patient’s concerns provides a great starting point for healthcare staff to use to raise the patient’s level of comfort. 

Assess for communication barriers. 

Language barriers, sensory impairment,  and other factors such as mistrust or shame can hold the patient back from expressing feelings and concerns. 

Assess the patient’s pain level. Use appropriate pain scales to assess pain levels. 

Pain may be considered a form of discomfort that should be addressed. During this assessment, it can be established what pain level is acceptable for the patient and a goal level of pain control. 

Obtain a detailed history about aspects that might affect comfort level and evaluate how these may affect the patient’s comfort in the recovery process. 

History of anxiety, depression, past surgeries, and comorbidities may contribute to the current illness and decrease patients’ comfort. For example, a patient with a history of chronic pain will have a more complicated approach to pain management after surgery than someone that does not experience chronic pain from a previous injury. Likewise, a patient that suffers from anxiety will have a different treatment plan than one who doesn’t have anxiety. 

Assess the patient’s coping strategies to cope with discomfort. 

Coping strategies that have worked in the past might not work anymore. This assessment is necessary so that healthcare staff can offer new coping techniques to the patient. 

Nursing Interventions for Impaired Comfort 

Establish a trusting relationship with the patient. 

Building trust can help facilitate treatment plans, and it is more likely for the patient to express his or her concerns to healthcare staff. 

Make environmental changes to improve the patient’s comfort. 

Using a white noise machine 
Decreasing environmental stimuli such as noisy television 
Adjusting lighting in the room
Reducing frequent visits from family members 
Offering earplugs and eye mask
Adjusting the temperature in the room

Environmental changes to the patient’s preference might give him or her a feeling of control and increase comfort.  

Provide several relaxation techniques that may decrease discomfort. 

Guided imagery/visualization 
Deep breathing exercises 
Meditation 
Music therapy 

These techniques help shift the focus away from the currently experienced pain, anxiety, and tension and instead focus on more pleasant experiences.  

Reposition the patient frequently and encourage ROM exercises. 

Changes in patient position help relieve pressure points and may help with pain management. In addition, early mobilization might help with discomfort from bed rest. 

Administer pain medication as ordered. 

Pain, if not the source of discomfort, can be an additional stressor to already existing discomfort and make the patient’s experience worse.

Offer heat or cold application as a nonpharmacological pain treatment option. 

Heating blankets and ice packs can be used as additional tools to treat pain or elevate comfort level if a patient is hot or cold. 

Consider healing touch if the patient doesn’t tolerate any other form of stimuli such as back rubs or ROM. 

Healing touch is a form of alternative medicine that derives from the thought of human touch lowering cortisol levels in the body. Cortisol is a stress hormone that raises blood pressure, blood sugar, and heart rate. Healing touch may, therefore, lower stress and anxiety. 

Offer grooming supplies (toothbrush, deodorant, lip balm, mouthwash) to the patient. 

These seemingly small gestures can make a big difference in uncomfortable situations such as hospitalizations and help bring a sense of normalcy and routine to unprecedented times. 

Use a humidifier when oxygenating a patient. 

Oxygenation can often cause dry mucus membranes and nose bleeds. Humidification makes the treatment more tolerable. 

Offer lemon swabs (if not contraindicated)  for NPO patients (nothing by mouth) and perform routine mouth care frequently. 

Nothing to drink and eat for an extended period can dry mucus membranes. Frequent application of moist agents such as lip balm and using glycerin swabs can help improve comfort. 

Use communication techniques such as listening and empathy. 

The feeling of being heard and understood communicates acceptance and promotes comfort in an unfamiliar environment. 

Praise and support the patient whenever he or she can use a newly learned coping skill successfully. 

Complimenting on achievements gives the patient a sense of accomplishment and increases confidence. This may increase comfort levels. 

Keep a calm attitude when interacting with the patient. 

Nervousness or rushed attitudes might be projected onto the patient, where the patient may feel nervous and uncomfortable. A calm attitude might likely help the patient keep calm as well.

Explain procedures and routine patient care before initiating care. 

Letting the patient know about what to expect may take away feelings of anxiety and promote comfort. 

Suggest appropriate referrals if necessary to increase comfort. 

Some illnesses may need further evaluation by more specialized providers and staff. 

Let the patient know that the services of a chaplain are available. 

Spiritual guidance in sickness can help boost morale and improve the patient’s outlook on his or her health condition. 

More Care Plans

Fatigue Nursing Diagnosis & Care Plan

Ineffective Coping

Ineffective Health Maintenance [Care Plan]

Activity Intolerance Nursing Diagnosis & Care Plan

Knowledge Deficit [Care Plan]

References:

Umbreit AW. Healing touch: applications in the acute care setting. AACN Clin Issues. 2000 Feb;11(1):105-19. doi: 10.1097/00044067-200002000-00012. PMID: 11040557.

Ackley, B., & Ladwig, G. (2014). Nursing diagnosis handbook (10th ed). Maryland Heights: Mosby Elsevier.

https://www.hopkinsmedicine.org/patient_care/patients-visitors/admission-discharge/managing-pain-comfort.html

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