Activity And Rest Flashcards
How is restless leg syndrome treated?
Symptoms may be eased by change in diet and exercise.
Non-Pharmacologically by massage, heat or cold therapy, and maintaining a regular sleeping pattern.
Severe RLS- medication may be helpful.
Dopamine agonists ropinirole (equip) which act on the neurotransmitter dopamine in brain.
Anticonvulsants, such as gabapentin (neurontin) or anti-seizure drugs.
Opioids- ocycodone
Benzodiazepines- Valium
How is obstructive sleep apnea treated?
Lifestyle changes: loose weight, avoid alcohol or sedative at bedtime. Avoid sleeping on back may help
The cpap: continuous positive airway pressure. Keep windpipe open during sleep and prevents episodes of blocked breathing.
How is insomnia treated?
Mild-‘practice good sleep hygiene.
Severe- sleeping pills. Rapid, short acting drugs may help you avoid drowsiness the following day. Avoid using over the counter meds., b/c undesired side effects and loose their effectiveness over time.
Chronic- first treat underlying conditions or health problems that are causing insomnia. Behavioral therapy
Ambien
If sleep apnea is left untreated:
Can cause heart arrhythmias, heart failure, high blood pressure, stroke
Stages of sleep
NREM sleep is the ,arrest percentage of sleep time, aprox 75-80%. NREM is divided into three stages
Stage 1 is the begging of sleep, with slow eye movements,mand is a transition phase from wakefulness to sleep.,1-7 min. The person can be easily awakened
Stage 2- sound sleep. Heart rate slows down and body temp drops. 10-15 min
Stage 3- deep or slow wave-sleep. It is the deepest stage of sleep. This stage lasts 20-40 min. Dreaming is more common in this stage than in other stages of NREM sleep, although not as common as in REM sleep.
REM sleep- accounts for 20-25% of sleep. REM sleep follows NREM sleep. In a healthy adult REM sleep occurs 4-5 times during a period of 7-8 hrs of sleep. This stage is considered paradoxic because the brain waves resemble wakefulness. rEM sleep is thought to be important for memory consolidation and is the period when the most vivid dreaming occurs.
Osteoarthritis
Insidious onset , aka degenerative joint
Cartilage is a natural shock absorber, cushions the ends of bones and reduces friction in healthy joints.
Treatment for osteoarthritis
Balance rest and activity
Joint immobilization should not be prolonged due to stiffness
Cane, walker, crutches
Heat therapy is helpful for stiffness.
Cold therapy is used to reduce inflammation.
Weight reduction (diet, exercise) low impact exercise- swimming, walking or bicycling, yoga and massage
Training with light weights can help by stretch ending the muscles that surround the joint.
Drug treatment for osteoarthritis- over the counter anti inflammatory meds
Also pain relieving creams- aspercreme contains salicylic acid help with pain relief and decrease in joint inflammation.
Nutritional supplements
-glucosamine, chondrotin sulfate (essential for the formation of cartilage and synovial fluid)
Glucocorticoids (prednisone)
Intraarticular -directly into joint space
Also surgery
Rheumatoid arthritis is a systemic inflammatory disease
The joints are usually the most affected, however the inflammation can affect organs And other areas of body too.
Usually affects joints symmetrically (on both sides equally) may initially begin in a couple of joints only, and most frequently attacks the wrists, hands, knees, ankles.
Rheumatoid arthritis is a disease that
Waxes and wanes (comes and goes)
RA
The synovial membrane becomes inflamed, resulting in the production of excessive synovial fluid.
Synovitis- synovial membrane also thickens with inflammation
Gout-
The presence uric acid crystals causes inflammatory response.
Gouty arthritis
Recurrent attacks of painful joint inflammation
Gout
Formation of tophi
Lumps of collected crystals under the skin, in the joints and in bone.
Gout
Kidney stones- uric acid stones
Gout nephropathy- impaired kidney function, obstruction
Uric acid level, gout
Purines are nucleotide bases found in plant and animal cells.
Example- adenine, guanine are two of the four bases in DNA
Purines are metabolized to uric acid
Increased uric acid production
Failure of the kidneys to filter out uric acid.
Causes of gout
Although purine rich foods do not cause gout alone, they can trigger and exacerbation of the disease.
Diagnosis of gout
Serum uric acid levels >6mg/dl
24 hr urine to test for levels of uric acid elimination
Symptoms
Drug therapy
NSAIDs
Colchicine- prevents activation and migration of neutrophils, though to mediate some gout symptoms.
Decreases uric acid crystal formation
Colchicine and probenecid (combo drug) probenecid helps increase the excretion of uric acid in the urine.
Allopurinol- reduces the production of uric acid by inhibiting the biochemical reactions immediately preceding its formation.
Adduction
Bringing limbs into body- adding to
Abduction- lifting arms away from body
Abductor pillow after total hip replacement -no internal rotation of hips, do not want toes to pint to each other.
Abduction- lifting arms away from body
Abductor pillow after total hip replacement -no internal rotation of hips, do not want toes to pint to each other.
Goals/ outcomes for patient with nursing diagnosis of impaired mobility
Sit up at side of bed and stand with walker using TTWB toe touch weight bearing on affected led with assistance of physical therapist with minimal discomfort. (Rates pain at 4 or below)
Log roll every 2 hrs as ordered
Consume 100% of meals
Drink 700 mil fluid from 0700 to 1300
Skin remains fully intact from head to toe
What cause contractures?
Brain or nervous system disorders Scarring after traumatic injury Inherited disorders Nerve damage Reduced use- immobility Scarring after traumatic injury or burn
Treatment of contracture
Manual treatment options for contractures include: stretching, heat therapy and exercise. Together these techniques can restore mobility and build critical muscle.
Mechanical treatment options- CPM continuous passive motion machines to increase mobility.
Treatments for contracture
Casting or splinting- used to provide a consistent stretch of the affected soft tissue. After the initial cast or splint is removed, a serious of casts is used to make a regular adjustment in order to improve mobility over time.
Surgery, manipulation of the joint as the patient is under general anesthesia.
Muscle relaxants- some, Valium
