basix exam week 11

Why is a partial bath often better than a daily full bath for older adults?

It reduces skin dryness, energy expenditure, and fall risk while maintaining hygiene of face, hands, axillae, perineum.
Rationale: Aging skin has ↓ oil/sweat production & thinner epidermis; daily full baths strip lipids and can cause tears.

What do you teach families about giving a bed bath?

Gather supplies; warm room; provide privacy; hand hygiene & gloves; wash clean-to-dirty, distal-to-proximal; keep patient covered; change water as needed; dry thoroughly.
Rationale: Sequencing prevents contamination and heat loss; drying prevents maceration & skin breakdown.

When is safety-razor shaving contraindicated, and key steps to assist?

Contra: anticoagulants, thrombocytopenia, bleeding disorders, confused/uncooperative clients, facial wounds. Steps: soften hair with warm water, apply shaving cream, short downward strokes, skin taut, aftercare.
Rationale: Minimizes bleeding/skin injury.

Items & steps for oral hygiene and denture care?

Soft brush, fluoride paste, floss, lip balm; for dentures: line sink/towel, cool water rinse, denture brush/cleanser, store moist in container.
Rationale: Protects teeth/gums and prevents denture warping or breakage.

How to prevent the main hazard during oral care for an unconscious client?

Turn lateral, use Yankauer suction, minimal fluid with foam swabs, avoid finger in mouth.
Rationale: Aspiration is the chief risk; side-lying + suction protects airway.

Common skin irritants and what to do?

Urine/stool, sweat, adhesives, harsh soaps. Use pH-balanced cleansers, barrier creams, frequent changes, gentle adhesive removers.
Rationale: Reduces contact dermatitis and moisture-associated skin damage.

Head lice: what to do, teach, and how to treat?

Use pediculicide per directions, fine-tooth comb, wash linens/hats hot water/dryer, bag unwashables 2 weeks, avoid sharing items, treat close contacts PRN.
Rationale: Breaks life cycle and prevents reinfestation.

Techniques to prevent denture damage during cleaning?

Line sink, hold securely, use cool water, approved cleanser, avoid hot water/abrasives, store in water.
Rationale: Prevents dropping and warping.

Which clients require extreme caution with nail care?

Diabetes, peripheral vascular disease, neuropathy, anticoagulated, immunocompromised.
Rationale: Poor healing/bleeding risk—usually file only; podiatry referral.

Reasons for sound disturbances with hearing aids?

Low battery, cerumen, poor fit, volume too high, feedback from loose seal, moisture damage.
Rationale: Troubleshooting restores function and prevents further ear irritation.

Ways to modify the environment to promote comfort, rest, and sleep?

Dark/quiet room, cool temp, limit nighttime interruptions, cluster care, comfortable bedding, reduce screens/caffeine near bedtime.
Rationale: Optimizes sleep hygiene and circadian cues.

Functions of sleep & recommended amounts?

Tissue repair, memory consolidation, hormone regulation, immune function. Adults ~7–9 h; teens ~8–10; older adults ~7–8 with more awakenings.
Rationale: Adequate sleep supports healing and cognition.

List good sleep hygiene practices to teach.

Consistent schedule, wind-down routine, no heavy meals/ETOH late, limit naps, exercise early, screen cutoff, bedroom only for sleep/sex.
Rationale: Strengthens stimulus control and sleep drive.

Phases of sleep and differences?

NREM 1–3 (light → deep/slow-wave) and REM (dreaming, atonia). N3 = restoration; REM = memory/emotion processing.
Rationale: Each stage has distinct physiologic roles.

General trend in sleep needs with aging?

Total time slightly ↓ or stable; ↑ sleep latency & awakenings; ↓ deep sleep; earlier bed/wake times.
Rationale: Normal aging changes; set expectations.

Factors affecting sleep?

Pain, anxiety, meds/caffeine, ETOH, environment, shift work, illness, nocturia, reflux, apnea.
Rationale: Identifying contributors guides targeted fixes.

Drug categories that affect sleep?

Stimulants, decongestants, steroids, beta-blockers (vivid dreams), SSRIs/SNRIs, caffeine, alcohol (fragments sleep), sedative-hypnotics.
Rationale: Review meds when assessing insomnia.

Techniques for assessing sleep patterns?

Sleep diary, partner report, Epworth scale, Pittsburgh Sleep Quality Index, actigraphy, targeted history.
Rationale: Objective and subjective data direct care.

Types of sleep disorders, S/S, and treatments (overview)?

Insomnia (CBT-I, sleep hygiene), OSA (CPAP, weight loss), RLS (iron if low, dopamine agents), narcolepsy (stimulants, safety), circadian disorders (light therapy).
Rationale: Match therapy to pathophysiology.

Techniques for promoting sleep?

CBT-I strategies, relaxation, stimulus control, sleep restriction, light exposure AM, limit naps, address pain.
Rationale: Nonpharm first-line; durable benefits.

Phases of the pain process?

Transduction → Transmission → Perception → Modulation.
Rationale: Interventions target different phases (e.g., NSAIDs at transduction).

Differences: pain perception, threshold, tolerance—and nursing focus?

Perception = conscious awareness; threshold = point stimulus becomes pain; tolerance = amount one will endure. Nurse: assess individually, avoid bias, tailor interventions.
Rationale: Wide variability—use patient report as gold standard.

What meds can increase the effect of an analgesic?

Adjuvants (antidepressants, anticonvulsants), NSAIDs with opioids (multimodal), caffeine with some analgesics.
Rationale: Synergy allows lower opioid dosing.

Types of pain and common S/S?

Acute vs chronic; nociceptive (somatic/visceral) vs neuropathic; S/S: guarding, grimace, ↑ HR/BP (acute), sleep/mood changes (chronic).
Rationale: Type guides therapy (e.g., neuropathic → gabapentinoids).

Differentiate acute vs chronic pain.

Acute: sudden, protective, autonomic signs, resolves with healing. Chronic: >3–6 mo, persists, few autonomic signs, functional impacts.
Rationale: Distinction affects goals (cure vs function).

Components of a basic pain assessment—what do you ask?

Location, intensity (0–10), quality, onset/duration, aggravating/relieving, pattern, function impact, previous treatments, goals.
Rationale: Structured assessment improves management.

Devices for pain: types, when used, & assessments?

TENS, heat/cold packs, splints, immobilizers, PCA pumps. Assess site, skin integrity, settings, effectiveness, safety.
Rationale: Non/low-risk modalities augment meds.

Common misconceptions about pain?

Pain is visible,” “addiction is inevitable,” “sleeping = no pain,” “vital signs reflect pain level.”
Rationale: Myths lead to undertreatment—use patient self-report.

Nonpharmacologic pain methods & when used for age groups?

Relaxation, breathing, distraction, music, massage, heat/cold; for kids—distraction/play; older adults—gentle movement, heat, CBT.
Rationale: Useful adjuncts and sometimes primary therapy.

Common pain intensity tools & matching age groups?

Numeric 0–10 (adults/teens), Wong-Baker FACES (≥3 yrs), FLACC (infants/nonverbal), PAINAD (advanced dementia).
Rationale: Age/ability appropriate scales improve accuracy.

Physiologic mechanisms for managing pain?

Endorphins, descending inhibitory pathways, gate-control theory (non-painful input closes “gate”).
Rationale: Basis for TENS, massage, and cognitive strategies.

Drug categories used alone or in combination for pain?

Nonopioids (acetaminophen, NSAIDs), opioids, adjuvants (antidepressants, anticonvulsants, muscle relaxants), topical agents (lidocaine, capsaicin).
Rationale: Multimodal regimens improve relief and safety.

CAM therapies for pain?

Acupuncture, yoga, tai chi, mindfulness/meditation, aromatherapy, chiropractic.
Rationale: Evidence varies; many improve function and coping.

Define addiction and how fear of it affects pain care.

Addiction = chronic disease with compulsive use despite harm; distinct from tolerance/dependence. Fear leads to undertreatment—use risk assessment & monitoring.
Rationale: Accurate terminology supports balanced care.

Most common reason clients request frequent analgesic doses?

Inadequate pain control (wear-off, breakthrough pain).
Rationale: Reassess regimen before assuming misuse.

Define placebo and basis for positive effect.

Inert treatment producing perceived benefit via expectation and conditioning; not ethically given deceptively for pain.
Rationale: Placebo effect is real, but deception violates autonomy.