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Recognizing Signs of Client Discomfort

Unit 7 Lesson 2

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Describe subjective and objective signs of pain and discomfort in clients
Identify the role of the nurse’s aide in documenting signs of pain

Student Learning Outcomes

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Discomfort in Clients

Physical or emotional unease causing distress
Can be both subjective (reported) and objective (observed)
Role of Nurse’s Aide

Integral in identifying both types of signs during routine care
Ensures timely intervention and comfort provision

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

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Subjective Signs of Discomfort

Directly communicated by the client
Examples: “My stomach hurts,” “I feel achy when I walk”
How to Document

Quote the client's exact words
Example entry: The client stated, “My stomach hurts.”

Challenges and Considerations

Requires attentive listening and accurate interpretation
Important to consider client’s context and emotional state

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

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Critical Thinking Question

A client tells the nurse’s aide, “I feel achy when I walk.” How should the nurse’s aide document this information?

A) Write a detailed narrative describing the client’s general mood and condition.

B) Document the statement exactly as the client said it, using quotes.

C) Paraphrase the statement to make it more concise and easier to understand.

D) Record the statement as a potential symptom of a suspected condition.

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Objective Signs of Discomfort

Non-verbal cues observed by the caregiver
Include body language like grimacing, guarding, rocking, or moaning
Critical for clients who cannot verbally communicate
Enhances understanding of client’s condition

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

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Objective Signs of Discomfort continued…

Recognizing Non-Verbal Indicators

Grimacing

Facial expressions showing pain

Guarding

Protecting or holding an injured body part

Rocking or Rubbing

Movements indicating discomfort

Moaning

Sounds expressing pain or distress

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

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Critical Thinking Question

A nurse’s aide observing a client with dementia notices the client is grimacing and rocking back and forth in their chair, but they do not verbally express any discomfort. What steps should the nurse’s aide take to address this situation?

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Documentation of Objective Signs

Observation Skills

Be attentive to subtle changes in behavior and expression
Use systematic approaches like PAINAD for consistency

Documentation Practices

Record observations accurately and promptly
Ensure descriptions are clear and detailed

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

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Documentation of Objective Signs continued…

Using the PAINAD Tool

Helps assess pain in clients with advanced dementia
Focuses on five key behaviors

Breathing
Vocalization
Facial expression
Body language
Consolability

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

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Role of the Nurse Aide

Regularly monitor and assess for signs of discomfort
Document both subjective and objective data accurately
Communication with Nursing Team

Report findings clearly and promptly
Collaborate to develop appropriate care plans

Ethical Considerations

Maintain client dignity and comfort
Ensure confidentiality and sensitivity in documentation

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

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Critical Thinking Question

During the nursing assistant’s shift, a client tells states, “My stomach hurts a lot today.” After documenting this subjective data, what should be the next course of action for the nursing assistant?

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References

Sandquist-Reuter, M. (2023). Nursing Assistant. WisTech Open. https://wtcs.pressbooks.pub/nurseassist/

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