Explain the importance of asking the client about use of complementary therapies.

Comfort, Pain, Sleep, and CAM Worksheet

Instructions:  Every answer have to be under the question

General Content Questions:

1. Explain the importance of asking the client about use of complementary therapies.
2. Provide two definitions of pain.
3. Go to the following website: http://www.thecomfortline.com/.  Define comfort.

4. State the most common misconceptions regarding pain.
5. State the most common misconceptions regarding pain in infants.
6. State the most common misconceptions regarding pain in older adults.
7. Describe the nurse’s role in pain management.
8. State how the nurse assesses pain.
9. What pain scale does the nurse use for verbal patient? For non-verbal patients and young children?
10. Describe how culture can affect the expression of pain.
11. Name at least three guidelines that help nurses individualize pain management therapy.
12. Name at least five methods of nonpharmacologic pain relief interventions.
13. Describe the symptoms of an individual who has inadequate amounts of sleep.
14. List the drugs that disrupt sleep.
15. What are the clinical manifestations of insomnia?
16. What is narcolepsy?
17. Describe common treatments and management methods for narcolepsy.
18. Briefly define sleep apnea. Describe the three types of sleep apnea and risk factors.
19. What is parasomnia? Provide at least three examples.
20. List at least three nursing interventions to promote sleep in acute care.

Sleep Case Study:

Sheena, a 42-year-old woman, is referred to the sleep disorders center with a complaint of chronic, severe insomnia affecting her daytime functioning. The single mother of three teenage boys, she first experienced insomnia eight years ago when bankruptcy threatened her small business. Although the business recovered a year later, her insomnia has remained almost unchanged over the next eight years.

Medication History: She has unsuccessfully taken Ativan (lorazepam), Restoril (temazepam), and Ambien (zolpidem tartrate).  Although an initial benefit was derived from each of these medications, she gave up on each of them after a few weeks because of their side effects and/or lack of efficacy.  She is currently trying Melatonin, an over the counter sleep aid.

1. What are the risks associated with use of benzodiazepines for treatment of insomnia?
2. What are the suggested dosing practices for benzodiazepines for treatment of insomnia?
3. What risks are associated with regular use of any sleep medication?

Social History:  Sheena feels she is just “hanging on by her fingernails,” and that looking after her business and her sons takes all of her energy. Her insomnia has forced her to give up her social life, including her fly-fishing hobby and gym workouts. She feels depleted and stressed all of the time.

Review of Sleep Pattern:  Sheena tries to go to bed around 11:00 PM. She usually falls asleep in less than 15 minutes, but occasionally it seems to take her hours to fall asleep. She wakes up three to four times per night, and at least one of these awakenings lasts two to three hours. She  gets frustrated when she “sees the clock ticking away;” in response, she usually gets out of bed to work on the computer until she becomes sleepy, which often does not happen until around 5:30 AM — which is the time she should be getting up. At that time, Anna falls into a very deep sleep and may not awaken until 7:00 or 8:00 AM.

1. What two nursing diagnoses are appropriate for this patient (include “related to” and “as evidenced by”)?
2. List at least four suggestions the nurse can give the patient when teaching about promoting sleep.