Basic Nursing Care & Comfort - Concept Map
Holistic Basic Nursing Care—Meeting Fundamental Patient Needs Through Hands-On Interventions
Related concepts
Personal Hygiene
Sub concepts
- Complete bed bath
- Partial bath
- Therapeutic baths (sitz bath)
- Eye care (inner to outer canthus)
- Perineal care (front to back)
- Oral care for unconscious patients (side-lying)
- Foot care (especially diabetic patients)
- Hair and nail care
- Denture care
- Water temperature 43–46°C
- Principles: clean to dirty, distal to proximal
Relationship to central
Core foundation for cleanliness, comfort, skin integrity assessment, and psychological well-being
Positioning & Body Alignment
Sub concepts
- Fowler's (30–45° semi, 60–90° high)
- Semi-Fowler's (30°)
- Supine/dorsal recumbent
- Prone
- Lateral/side-lying
- Sims' (semi-prone, left side)
- Trendelenburg & Reverse Trendelenburg
- Orthopneic
- Lithotomy
- Knee-chest
- Repositioning every 2 hours
- Trochanter roll
- Hand roll
- Footboard/high-top sneakers
- Trapeze bar
- Body alignment principles
Relationship to central
Prevents complications, promotes comfort, maintains circulation, supports therapeutic outcomes
Body Mechanics
Sub concepts
- Widen base of support
- Bend hips and knees, not waist
- Keep back straight
- Use large muscle groups (legs)
- Load close to body at waist level
- Push/pull rather than lift
- Pivot feet instead of twisting
- Use mechanical aids
- Get help for heavy patients
- Lower bed rails, raise bed to working height
- Face direction of movement
Relationship to central
Protects both patient and nurse from injury during care delivery
Mobility & Immobility Management
Sub concepts
- Hazards: contractures, muscle atrophy, osteoporosis
- Hazards: DVT, orthostatic hypotension, increased cardiac workload
- Hazards: hypostatic pneumonia, atelectasis, decreased chest expansion
- Hazards: constipation, decreased appetite
- Hazards: urinary stasis, renal calculi, UTI
- Hazards: pressure injuries
- Hazards: depression, disorientation
- Active ROM exercises
- Passive ROM exercises
- Early ambulation
- Deep breathing and coughing
- Incentive spirometry
- Leg exercises
- Anti-embolism stockings
- Sequential compression devices
- Anticoagulants (enoxaparin, heparin)
- Adequate hydration
Relationship to central
Prevents serious complications and maintains functional ability
Pressure Injury Prevention
Sub concepts
- Stage 1: non-blanchable intact skin erythema
- Stage 2: partial-thickness dermis loss or intact/ruptured blister
- Stage 3: full-thickness loss with subcutaneous fat visible
- Stage 4: full-thickness with exposed bone/tendon/muscle
- Unstageable: base obscured by slough/eschar
- Deep tissue injury: persistent non-blanchable discoloration
- Reposition at least every 2 hours
- Every 1 hour in chairs or shift weight every 15 minutes
- Pressure-redistributing surfaces
- Heel offloading
- Keep skin clean and dry
- Manage incontinence promptly
- Do NOT massage reddened areas or bony prominences
- Adequate nutrition (protein, vitamin C, zinc)
- Adequate hydration
- Avoid shearing and friction
- Keep head of bed ≤30°
- Braden Scale risk assessment
Relationship to central
Critical patient safety intervention addressing a leading cause of hospital-acquired injury
Rest & Sleep Promotion
Sub concepts
- NREM sleep stages (progressive to deep slow-wave)
- REM sleep (dreaming, brain activation)
- Sleep cycles ~90 minutes
- Insomnia
- Sleep apnea (CPAP treatment)
- Narcolepsy
- Restless legs syndrome
- Parasomnias (sleepwalking, night terrors, bruxism)
- Age effects on sleep
- Illness and pain impact
- Environmental factors (noise, light)
- Lifestyle and shift work effects
- Stress and anxiety
- Stimulants (caffeine, nicotine)
- Alcohol effects
- Medications
- Hospital sleep disruption
- Consistent schedule
- Comfortable environment
- Avoid caffeine and heavy meals
- Relaxation techniques
- Limit daytime naps
- Cluster nursing care
- Sedative-hypnotics as last resort
Relationship to central
Restores physical and mental function; essential for patient recovery
Comfort Measures
Sub concepts
- Positioning and support with pillows
- Back rubs and massage
- Temperature control
- Quiet environment
- Cleanliness and odor control
- Non-pharmacologic pain relief
- Heat therapy (vasodilation, relaxation)
- Cold therapy (reduce swelling, pain)
- Skin protection during heat/cold
- Limit application ~15–20 minutes
- Caution with impaired sensation
- Caution with impaired circulation
- Relaxation techniques
- Guided imagery
- Distraction
- Therapeutic touch
- Presence and listening
Relationship to central
Holistic approach addressing physical, psychospiritual, environmental, and sociocultural dimensions
Transfer, Ambulation & Fall Safety
Sub concepts
- Dangle before ambulating
- Assess for orthostatic hypotension
- Assess for dizziness
- Gait/transfer belt use
- Nurse on weaker side
- Cane held on stronger side
- Advance cane with weaker leg
- Fall response: ease down slowly
- Protect head during fall
- Slide patient down your leg
- Keep own back straight
- Wide base of support
- Lock all wheels before transfer
Relationship to central
Maintains patient independence while preventing injury during mobility
Cultural & Filipino Context
Sub concepts
- Family presence and involvement (pakikisama)
- Family caregivers (bantay) participation
- Respect for modesty
- Spiritual and religious support
- Religious practice accommodation
- Trust and cooperation through cultural sensitivity
- Family teaching and engagement
Relationship to central
Ensures culturally sensitive, family-centered care appropriate to Philippine nursing practice (RA 9173)
Nursing Process Application in Basic Care
Sub concepts
- Assessment: skin integrity, mobility, nutritional status, pain
- NANDA diagnoses: Impaired Physical Mobility, Risk for Pressure Injury, Self-Care Deficit, Pain, Insomnia
- Maslow's hierarchy: addressing physiologic needs first
- NCM levels: Level 1 (assessment) through Level 4 (complex evaluation)
- Planning: preventive and therapeutic interventions
- Implementation: patient-centered, safe, culturally appropriate
- Evaluation: goal achievement, complications prevention
Relationship to central
Systematically applies assessment, diagnosis, planning, implementation, and evaluation to basic care
Concept connections
- Personal HygieneSkin Integrity AssessmentHygiene provides optimal opportunity to assess skin during bathing, particularly identifying early pressure injury signs or other dermatologic changes
- Personal HygieneInfection PreventionRemoves microorganisms and body secretions, reducing nosocomial infection risk and promoting wound healing
- Positioning & Body AlignmentPressure Injury PreventionProper positioning and regular repositioning (every 2 hours) are primary interventions to prevent pressure injuries by reducing unrelieved pressure on bony prominences
- Positioning & Body AlignmentMobility & Immobility ManagementCorrect positioning prevents contractures and maintains proper body alignment; essential component of immobility hazard prevention
- Body MechanicsTransfer & AmbulationProper body mechanics protect both nurse and patient during transfers and ambulation; prevents caregiver injury and patient falls
- Body MechanicsMobility & Immobility ManagementSafe body mechanics enable safe early mobilization and ROM exercises, preventing complications of immobility
- Mobility & Immobility ManagementPressure Injury PreventionEarly ambulation and repositioning reduce pressure injury risk; immobility is a major risk factor for pressure injuries
- Mobility & Immobility ManagementDeep Vein Thrombosis PreventionLeg exercises, early ambulation, compression stockings, and anticoagulants (e.g., enoxaparin) prevent DVT from venous stasis during immobility
- Mobility & Immobility ManagementRespiratory ComplicationsEarly mobilization, deep breathing, coughing, and incentive spirometry prevent hypostatic pneumonia and atelectasis
- Pressure Injury PreventionNutrition & HydrationAdequate protein, vitamin C, zinc, and hydration support tissue healing and prevent calculi; malnutrition increases pressure injury risk
- Rest & Sleep PromotionComfort MeasuresNon-pharmacologic comfort measures (relaxation, environment control, clustering care) promote sleep quality and recovery
- Comfort MeasuresPain ManagementNon-pharmacologic comfort interventions (heat/cold, positioning, massage, presence) are first-line approaches to pain relief
- Heat & Cold TherapyPain & Swelling ManagementHeat promotes vasodilation and relaxation; cold reduces swelling and pain—timing (15–20 minutes) and skin protection are critical
- Transfer & AmbulationFall PreventionPre-ambulation assessment, gait belt use, proper positioning, and fall response protocols minimize fall risk and injury
- Transfer & AmbulationOrthostatic Hypotension ManagementDangling before ambulation and assessing for dizziness/hypotension before standing prevent syncope and falls
- Cultural & Filipino ContextFamily-Centered CareInvolving family caregivers (bantay) and respecting pakikisama strengthens patient cooperation and care adherence under RA 9173
- Cultural & Filipino ContextPatient Dignity & ComfortRespecting modesty, spiritual needs, and cultural practices enhances therapeutic trust and comfort outcomes
- Nursing Process ApplicationAll Basic Care DomainsAssessment, diagnosis (NANDA), planning, implementation, and evaluation guide systematic, safe, evidence-based delivery of all basic care interventions
- Maslow's HierarchyBasic Nursing Care PrioritizationPhysiologic needs (hygiene, nutrition, elimination, rest) must be addressed before safety, belonging, and self-esteem needs
- NANDA Nursing DiagnosesIndividualized Care PlanningDiagnoses such as Impaired Physical Mobility, Risk for Pressure Injury, Self-Care Deficit, Pain, and Insomnia direct specific interventions for each patient
- Perineal CareInfection PreventionFront-to-back cleansing and proper technique prevent contamination of urinary and reproductive tracts
- Oral CareVentilator-Associated Pneumonia PreventionSide-lying positioning with suction and regular oral care (every 2–4 hours) reduce VAP risk in unconscious/intubated patients
- Braden Scale AssessmentRisk Stratification & Prevention IntensityLower Braden scores indicate higher pressure injury risk, guiding allocation of preventive resources and interventions
- NCM LevelsNursing Accountability & ScopeNCM levels define responsibility levels for assessment, diagnosis, and complex clinical decisions in basic care delivery under RA 9173
Diagrams
Basic Nursing Care & Comfort – Comprehensive Concept Hierarchy
Comprehensive mind map showing the central concept of Basic Nursing Care & Comfort with nine major domains and their sub-concepts. This visual hierarchy demonstrates how all topics in the chapter interconnect as essential components of holistic patient care, addressing Maslow's physiologic and safety needs while supporting patient comfort, dignity, and recovery.
Pressure Injury Prevention & Management Pathway
Flowchart illustrating the systematic approach to pressure injury prevention and management, from initial risk assessment through Braden Scale evaluation, implementation of preventive strategies, detection and staging of any pressure injuries, and escalation protocols. This reflects the nursing process of assessment, diagnosis, planning, implementation, and evaluation specific to pressure injury care.
Safe Patient Transfer & Ambulation Protocol
Flowchart detailing safe patient transfer and ambulation, emphasizing pre-ambulation assessment for orthostatic hypotension and dizziness, proper body mechanics for both nurse and patient, positioning relative to the weaker side, and critical fall response protocol. Demonstrates application of body mechanics principles and fall prevention within the nursing process.
Immobility Hazards & Prevention Strategies by Body System
Flowchart mapping immobility hazards across all body systems with corresponding prevention strategies. Illustrates the comprehensive nursing assessment and intervention approach to managing an immobilized patient, emphasizing early detection and system-specific preventive measures aligned with NANDA diagnoses such as Impaired Physical Mobility and related complications.
Positioning Selection Based on Clinical Indication
Flowchart demonstrating clinical decision-making for patient positioning based on therapeutic goals and clinical indications. Aligns specific patient positions with their therapeutic purposes (dyspnea relief, drainage, exam access, aspiration prevention) and emphasizes the critical nursing intervention of repositioning every 2 hours for immobile patients.
Sleep Cycle and Sleep Stages
State diagram illustrating the normal sleep architecture with NREM stages progressing to deep restorative slow-wave sleep, followed by REM sleep (dreaming and brain activation), with the complete cycle lasting approximately 90 minutes. Helpful for understanding factors that disrupt sleep and the physiological basis for sleep promotion interventions.