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