Overview

Each person's perception of pain is unique. Assessment of pain is considered the "fifth vital sign" (see Nursing Procedure 3.5 and Appendix A).
Cultural background may have a great impact on a client's pain threshold and pain tolerance, as well as on the client's expression of pain. The nurse must consider cultural impacts on the pain experience when planning care.
Heat and cold may have special cultural significance for some clients (e.g., Asians or Hispanics), who classify conditions accordingly and expect corresponding treatments. Table 10.1 lists "hot" and "cold" conditions.
Nurses must be sensitive to alternative pain relief measures used by clients and the cultural significance of those measures. Efforts should be made to reconcile religious rituals, herbal remedies, or other treatments with the established medical plan to facilitate culturally sensitive care.
The assessment of pain should include its location; duration; intensity; and precipitating, alleviating, and associated factors.
Appropriate duration of treatment is essential for the effective use of heat and cold.
Cold therapy causes vasoconstriction; reduces local metabolism, edema, and inflammation; and induces local anesthetic effects.
Heat therapy causes vasodilatation, relieves muscle tension, stimulates circulation, and promotes healing.
Tissue damage can result if:

Some major nursing diagnostic labels related to rest and comfort are altered comfort, risk of altered comfort, and anxiety.