Cognitive-Perceptual Pattern



Cognitive-Perceptual Pattern






Acute Pain (Specify Type and Location) (1978, 1996, 2002)



DEFINITION

Verbal or coded report of the presence of indicators of severe discomfort (pain) with a duration of less than 6 months (specify type and location [e.g., joint pain, low back, cervical, knee pain])


DEFINING CHARACTERISTICS


Diagnostic Cues



  • Report of severe discomfort (pain)

and one or more of the following:



  • Guarding behavior, protecting area


  • Muscle tension increased


  • Facial mask of pain (eyes lack luster, “beaten look,” fixed or scattered movement, grimace)


  • Restless, irritable


  • Autonomic responses not seen in chronic, stable pain (diaphoresis, blood pressure and pulse rate change, pupillary dilation, increased or decreased respiratory rate)


  • Distraction behavior (moaning, crying, pacing, seeking out other people and/or activities, restless)


  • Focus on self


  • Narrowed focus (altered time perception, withdrawal from social contact, impaired thought process)


  • Listless to rigid; antalgic positioning to avoid pain



OUTCOME


Pain Level



  • Severity: Absence of pain reports


ETIOLOGICAL OR RELATED FACTORS



  • Knowledge deficit (pain management)



HIGH-RISK POPULATIONS



  • Postsurgical (e.g., incisional pain)


  • Arthritis (e.g., joint pain)


  • Cardiac (e.g., chest pain)


  • Injuring agents (biological, chemical, physical, psychological-stress related); post-trauma, post-injury



Chronic Pain (Specify Type and Location) (1986, 1996)



DEFINITION

Severe discomfort (pain) with a duration of more than 6 months (specify type and location [e.g., joint pain, low back, cervical, knee pain])


DEFINING CHARACTERISTICS


Diagnostic Cues



  • Verbal report or observed evidence of severe discomfort (pain)


  • Severe discomfort (pain) experienced for more than 6 months

and one or more of the following:



  • Guarded movement


  • Altered ability to continue previous activities


  • Fear of reinjury


  • Facial mask (of pain)


  • Physical and social withdrawal


  • Anorexia


  • Weight changes


  • Delayed sleep onset, sleep deprivation



OUTCOME


Pain Level



  • Severity: Absence of pain reports


ETIOLOGICAL OR RELATED FACTORS



  • Knowledge deficit (chronic pain management)


HIGH-RISK POPULATIONS



  • Chronic physical, psychosocial disability (specify; e.g., cancer)



Ineffective Pain Self-Management (Chronic, Acute)



DEFINITION

Lack of use, or insufficient use, of techniques to reduce pain (e.g., pain medication requests, timing, positioning, distraction)


DEFINING CHARACTERISTICS


Diagnostic Cues



  • Communication (verbal or coded) of pain descriptors


  • Delayed requests for medication, lack of use of positioning, distraction, and other pain-management techniques

and one or more of the following:



  • Guarding behavior, protecting area


  • Self-focusing


  • Narrowed focus of attention (e.g., altered time perception, withdrawal from social contact, impaired thought process)


  • Distraction behavior (moaning, crying, pacing, seeking out other people and/or activities, restless)


  • Facial mask of pain (eyes lack luster, “beaten look,” fixed or scattered movement, grimace)


  • Muscle tone listless to rigid



OUTCOME



  • Employs pain management techniques


  • Severity: Absence of pain reports


ETIOLOGICAL OR RELATED FACTORS



  • Insufficient knowledge (specify)


HIGH-RISK POPULATIONS



  • Postsurgical (e.g., incisional pain; phantom pain)


  • Arthritis (e.g., joint pain)


  • Cardiac (e.g., chest pain)


  • Injuring agents (biological, chemical, physical, psychological-stress related)


  • Post-trauma



Impaired Comfort (2008, 2010)



DEFINITION

Perceived lack of ease, relief, and transcendence in physical, psycho-spiritual, environmental, and social dimensions


DEFINING CHARACTERISTICS



  • Anxiety


  • Crying


  • Disturbed sleep pattern


  • Fear


  • Inability to relax, restlessness


  • Irritability, restlessness


  • Moaning, sighing


  • Reports being uncomfortable


  • Reports being cold or hot


  • Reports distressing symptoms


  • Reports hunger


  • Reports itching


  • Reports lack of contentment in situation


  • Reports lack of ease in situation



OUTCOME


Comfort Level



  • Perception of physical and/or psychosocial ease


ETIOLOGICAL OR RELATED FACTORS



  • Insufficient resources (e.g., limited financial or social support)


  • Illness-related symptoms (specify)


  • Lack of environmental control


  • Lack of privacy


  • Lack of situational control


  • Noxious environmental stimuli


  • Treatment-related side effects (e.g., medication, radiation)



Readiness for Enhanced Comfort (2006)



DEFINITION

A pattern of ease, relief, and transcendence in physical, psychospiritual, environmental, and/or social dimensions that can be strengthened


DEFINING CHARACTERISTICS



  • Expresses desire to enhance comfort


  • Expresses desire to enhance feeling of contentment


  • Expresses desire to enhance relaxation


  • Expresses desire to enhance resolution of complaints



OUTCOME



  • Reports feeling of comfort



Uncompensated Sensory Loss (Specify Type/Degree)*



DEFINITION

Uncompensated decrease in visual, hearing, touch, smell, or kinesthetic acuity (specify degree of loss)


DEFINING CHARACTERISTICS


Diagnostic Cues



  • Vision: Inability to read newsprint or identify objects and persons


  • Hearing: Inability to identify whispered sounds or normally voiced words


  • Touch: Inability to discriminate various qualities or tactile sensations or absence of tactile perception


  • Smell: Inability to identify odors


  • Kinesthesia: Inability to identify extent, direction, or weight of movement of body or body part



OUTCOME



  • Employs compensation(s) for sensory loss (when cure not possible)



Sensory Overload



DEFINITION

Environmental stimuli greater than habitual level of input and/or monotonous environmental stimuli


DEFINING CHARACTERISTICS


Diagnostic Cues



  • Perceptual distortions of sensory stimuli


  • Amount or complexity of sensory stimuli exceeds the usual or desired level (periodic or continuous)


  • Presence of uninterrupted intense and/or unchanging stimuli (motor, monitor, light, voices)


Supporting Cues



  • Reduction in reasoning, problem-solving ability, and/or work performance


  • Reports sleep disturbances, nightmares


  • Disorientation (periodic or general)


  • Short attention span


  • Restlessness, increased muscle tension


  • Reports fatigue


  • Irritability, anxiety


  • Reports feelings of loss of control



OUTCOME



  • Reports desired level of sensory stimuli


ETIOLOGICAL OR RELATED FACTORS



  • Environmental complexity or monotony


HIGH-RISK POPULATIONS



  • Decreased cognitive capability (e.g., head injury)


  • Decreased stress tolerance


  • Intensive care monitoring



Sensory Deprivation



DEFINITION

Reduced environmental and social stimuli relative to habitual (or basic orienting) level


DEFINING CHARACTERISTICS


Diagnostic Cues



  • Amount of sensory stimuli less than usual or desired levels (auditory, visual, proprioceptive, reality-orienting input, time-orienting input)


  • Disorientation or confusion (periodic, general, nocturnal)

and/or



  • Hallucinations, delirium, paranoia


Supporting Cues



  • Apathy


  • Anxiety



OUTCOME



  • Reports desired level of sensory stimuli


ETIOLOGICAL OR RELATED FACTORS



  • Isolation (restricted environment)


  • Therapeutic environmental restriction (specify: isolation, intensive care, bed rest, traction, confining illness, incubator)


  • Socially restricted environment (specify: institutionalization, homebound, age debilitation, infant deprivation)


  • Uncompensated visual or hearing deficit


  • Impaired verbal communication


HIGH-RISK POPULATIONS



  • Congenital or acquired sensory loss


  • Social isolation


  • Therapeutic isolation



Unilateral Neglect* (1986, 2006)



DEFINITION

Perceptually unaware of and inattentive to one side of the body


DEFINING CHARACTERISTICS


Diagnostic Cues

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Jun 12, 2016 | Posted by in NURSING | Comments Off on Cognitive-Perceptual Pattern

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