NR226 Units 4, 5, and 6 Comprehensive Refresher

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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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51 Terms

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Functions of sleep and rest

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

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Rapid eye movement (REM) sleep

Associated with early brain development, cognition, and memory.

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Effects of lack of sleep and rest

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

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Sleep patterns of Neonates & infants

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

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Sleep patterns of Toddlers

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

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Sleep patterns of Preschoolers and school age children

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

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Electronic devices in adolescent's rooms

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

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Sleep patterns of Young and middle adults

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

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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.

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Physical illnesses affecting sleep

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

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Insomnia

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

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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.

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Narcolepsy

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

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Parasomnia

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

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Somnambulism

Sleepwalking.

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Examples of Parasomnias

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

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Interventions for impaired sleep

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

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Creating a Soothing environment

Low light/white noise, cluster care

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Understanding Pain

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

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Factors influencing pain

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

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Acute pain

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

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Physiologic responses to acute pain

Changes in VS, facial expressions, vocal expressions.

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Psychological responses to chronic pain

Social isolation, insomnia, malnutrition, depression.

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Primary nursing goal with chronic non-cancer pain

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

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Pain affects the quality of life and daily activities

Ability to work, attend school, and interact socially.

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Pharmacological interventions for pain

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

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Patient-controlled analgesia (PCA) devices

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

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Topical analgesics

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

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Transdermal analgesics

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

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Pain self-management strategies

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

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Relaxation techniques for pain

Guided imagery, yoga, music, distraction.

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Common Signs of Aging: Lungs

Decreased respiratory muscle strength, reduced salivary secretions.

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Common Signs of Aging: Gastrointestinal

Abdominal distention and stomach less tolerant of certain foods.

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Supportive Interventions for Older Adults

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

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Therapeutic communication techniques for older adults

validation therapy and reality orientation.

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Reflection

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

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Restating

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

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Acknowledgement

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

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Active Listening

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

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Normal Grief

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

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Anticipatory Grief

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

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Palliative Care

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

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Hospice Care

Comfort care at the end of life.

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PREOPERATIVE PHASE

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

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PREOPERATIVE PHASE: Gender

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

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PREOPERATIVE PHASE: Labs/diagnostics

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

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PREOPERATIVE PHASE: Minimizing risk for surgical wound infection

antibiotics, skin antisepsis, maintain normal fluid and electrolyte balance

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POSTOPERATIVE

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

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Assessing Bowel Elimination

change in appetite, intoleratnce to certain foods, abdominal pain

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Colorectal Cancer Risk Factors

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

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Ileostomy

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