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Fundamentals Exam 3 > Comfort > Flashcards

Comfort Flashcards

1
Q

Pain as an alterative to comfort

A
  • unpleasant sensory and emotional experience associated with actual or potential tissue damage
  • “pain is whatever the patient says it is, existing whenever they say it does”
  • 5th vital sign
  • relief of pain is a patient’s right
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2
Q

How pain is described

A
  • duration
  • intensity
  • etiology
  • location
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3
Q

sleep-rest disorders

A
  • insomnia
  • narcolepsy
  • parasomnias
  • RLS
  • sleep apnea
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4
Q

Non-modifiable risk factors for alterations ofcomfort

A
  • genetics affect susceptibility to diseases associated with discomfort
  • genetic disorders directly affect individual’s ability to perceive pain
  • genetic mutations associated with some sleep disorders
  • many psychiatric disorders have genetic components
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5
Q

Modifiable risk factors for alterations ofcomfort

A
  • personal perference
  • lifestyle habits
  • nutrition
  • smoking
  • alcohol use
  • sleep hygiene
  • occupation
  • culture
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6
Q

Assessment of sleep

A

patient hx

  • nursing interview
  • client’s culture affects how client perceives discomfort and pain
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7
Q

nursing interview for sleep assessment

A
  • client description of symptoms
  • pain scale
  • depression assessment
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8
Q

common questions for sleep assessment

A
  • when did it start?
  • meds?
  • environment conducive for sleep?
  • creepy, crawling legs?
  • limb jerking?
  • snore?
  • shift worker?
  • bedtimes?
  • caffeine, tobacco, alcohol?
  • street drugs?
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9
Q

diagnostic tests for sleep

A
  • primary test: Polysomnography (PSG) - sleep study

* Electroenceohalogram (EEG)

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10
Q

Polysomnography (PSG)

A

records client’s :

  • SpO2
  • HR
  • RR
  • eye and leg movement
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11
Q

Surgical procedures for sleep

A
  • usually surgery to remove obstruction
  • adenotonsillectomy
  • partial removal of the soft palate, uvula, and posterior lateral pharyngeal wall
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12
Q

Surgery is only considered if…

A

CPAP is not tolerated

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13
Q

adenotonsillectomy

A

commonly performed to treat OSA in children

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14
Q

OSA

A

obstructive sleep apnea

* surgery is done to remove the obstruction

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15
Q

sleep hygiene

A

variety of sleep practices that help individuals attain good-quality sleep

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16
Q

sleep practices for sleep hygiene

A
  • maintaining regular sleep/awake pattern
  • performing bedtime rituals
  • providing restful environment
  • promoting comfort/relaxation
  • minimize environmental stimuli
  • avoid fluid intake 90 mins before bedtime
  • regular exercise, but not before bed
17
Q

medications for sleep

A
  • primary: sedative-hypnotics

- occasionally used: antiparkinson drugs, opioids, and anti convulsants

18
Q

sedative-hypnotic

A

~anxiolytics
~barbiturates
~benzodiazepines

19
Q

Important characteristic for sleep meds

A

half-life of the drug

20
Q

infant considerations for comfort

A

~challenging to discern cause of discomfort

~may percieve pain to greater extent

21
Q

older adult considerations for comfort

A

~may have higher pain threshold but lower tolerance

~cognitive impairment and sleep disorders

22
Q

ethnicity considerations for comfort

A

be culturally competent

23
Q

age & developmental stage affect ability to describe pain

A

special considerations for assessing discomfort and promoting comfort for each stage

24
Q

NREM

A

~activity in the RAS is inhibitied
~75%-80% of sleep during the night
~4 stages

25
Q

NREM Stage 1

A

~very light sleep

~lasts a few minutes

26
Q

NREM Stage 2

A
  • light sleep
  • body processes continue to slow down
  • eyes still
  • HR and RR decrease slightly
  • body temp fall
  • 44%-55% of total sleep
  • requires more stimuli to waken than stage 1
27
Q

NREM Stage 3 & 4

A
  • deepest stages of sleep
  • deep sleep/delta sleep
  • HR & RR drops 20-30% below those exhibited during waking hours
  • difficult to arouse
28
Q

REM

A
  • usually recurs about every 90 minutes
  • lasts 5-10 minutes
  • dreams
  • brain is highly active
  • brain metabolism may increase as much as 20%
  • paradoxial sleep
  • distinctive eye movements
  • learning, thinking, organizing areas are stimulated during REM sleep

Fundamentals Exam 3 (6 decks)

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