NR226 Units 4, 5, and 6 Comprehensive Refresher

Flashcards for NR226 Units 4, 5, and 6 review (Pain, Sleep, Aging, Coping, Perioperative Nursing, Bowel Elimination)

Functions of sleep and rest

Restoration of biological processes, recovery from illness, memory consolidation, mental relaxation, preparation for wakefulness.

Rapid eye movement (REM) sleep

Associated with early brain development, cognition, and memory.

Effects of lack of sleep and rest

Decreased ability to concentrate, increased irritability, increased risk for chronic diseases.

Sleep patterns of Neonates & infants

Normally sleep 15-16 hours a day, approximately 50% is REM sleep.

Sleep patterns of Toddlers

Normally sleep 12 hours per day with nighttime waking and decreasing REM sleep is common.

Sleep patterns of Preschoolers and school age children

Require 9-12 hours a day, with the amount of sleep decreasing as the child ages.

Electronic devices in adolescent's rooms

Associated with poor sleep hygiene and quality, resulting in excessive daytime sleepiness (EDS)

Sleep patterns of Young and middle adults

Require 6-9 hours a night; insomnia becomes common as stresses of adulthood set in.

Sleep patterns of Older adults

Increase in sleep difficulties with age; less time is spent in deep, REM sleep; more frequent periods of NREM sleep occur.

Physical illnesses affecting sleep

Respiratory/heart disease, hypertension, nocturia, restless leg syndrome (RLS), and GI disorders.

Insomnia

Chronic difficulty in getting to sleep, waking up frequently during sleep, and/or inadequate sleep quality.

Obstructive sleep apnea (OSA) and central sleep apnea (CSA)

Sleep disorders characterized by difficulty/inability to breathe and sleep simultaneously due to lack of airflow.

Narcolepsy

Causes excessive daytime sleepiness (EDS) due to dysfunctional sleep and wake cycles.

Parasomnia

Sleep issues seen more often in children caused by autonomic nervous system abnormalities.

Somnambulism

Sleepwalking.

Examples of Parasomnias

Includes somnambulism (sleepwalking), night terrors, sleep paralysis, and nocturnal enuresis (bed-wetting)

Interventions for impaired sleep

Routine, avoiding food/drink/vigorous activity/screens, soothing environment.

Creating a Soothing environment

Low light/white noise, cluster care

Understanding Pain

Subjective; only the person experiencing the pain knows whether it is present and how it feels.

Factors influencing pain

Social, cultural, spiritual, previous experience with pain, anxiety, stress, poor coping skills, sleep deprivation.

Acute pain

Protective, warns of injury or illness, usually short but can threaten recovery.

Physiologic responses to acute pain

Changes in VS, facial expressions, vocal expressions.

Psychological responses to chronic pain

Social isolation, insomnia, malnutrition, depression.

Primary nursing goal with chronic non-cancer pain

Improved functional status with the encouragement of pharmacological and non-pharmacological management.

Pain affects the quality of life and daily activities

Ability to work, attend school, and interact socially.

Pharmacological interventions for pain

Analgesics, anesthetics, opioids, and non-opioids (NSAIDs).

Patient-controlled analgesia (PCA) devices

Allow clients to control and self-administer medication on demand.

Topical analgesics

Creams, gels, sprays, and patch medications (NSAIDs and lidocaine).

Transdermal analgesics

Drugs absorbed from a patch into the bloodstream with systemic effects.

Pain self-management strategies

Regular exercise, sleep hygiene, herbals, and nutrition practices.

Relaxation techniques for pain

Guided imagery, yoga, music, distraction.

Common Signs of Aging: Lungs

Decreased respiratory muscle strength, reduced salivary secretions.

Common Signs of Aging: Gastrointestinal

Abdominal distention and stomach less tolerant of certain foods.

Supportive Interventions for Older Adults

Supportive interventions encourage family visits, memory cues and compensation for sensory deficits.

Therapeutic communication techniques for older adults

validation therapy and reality orientation.

Reflection

Ask the client to reflect back to a time when they were successful in handling stressful situations in the past.

Restating

“What I hear is that you feel…” to restate using the same words as the patient to help them feel understood.

Acknowledgement

“It sounds like this is a very difficult time for you…”

Active Listening

“Tell me more about how you’re feeling…”

Normal Grief

Consists of normal behaviors, reactions to loss, and symptoms.

Anticipatory Grief

Process of 'letting go' before an actual death has occurred.

Palliative Care

The symptom management of a chronic or life-limiting illness.

Hospice Care

Comfort care at the end of life.

PREOPERATIVE PHASE

Begins with the decision to have surgery and lasts until transfer to the operating suite

PREOPERATIVE PHASE: Gender

Females of childbearing age will need to have a pregnancy test before surgery

PREOPERATIVE PHASE: Labs/diagnostics

Review all lab work and ensure that anesthesia has reviewed it as well

PREOPERATIVE PHASE: Minimizing risk for surgical wound infection

antibiotics, skin antisepsis, maintain normal fluid and electrolyte balance

POSTOPERATIVE

The postanesthesia care unit (PACU) phase begins with transport to the PACU and continues with recovery, which can be a long-term recovery

Assessing Bowel Elimination

change in appetite, intoleratnce to certain foods, abdominal pain

Colorectal Cancer Risk Factors

lack of physical activity, a low-fiber and high-fat diet, overweight and obesity

Ileostomy

Ostomy bag, stoma is made in the ileum (small intestine) and large intestine and rectum may or may not be removed