D-exam 5 presentations Flashcards
Functions of Sleep
restores
protiem
psych
Restores normal activity and balance among parts of nervous system
Protein synthesis, which allows repairs to occur
Psychological and emotional rest
Stages of sleep
circ
nrem
circadian rythmm- physcial mental behavioral changes in 24 hrs
Non-Rapid Eye Movement (NREM)
Stage I-closed,easy to wake up, lasts 5-10mins
Stage II-hr slows,temp drops, light sleep,10-25mins
Stage III-deep sleep stage
Stage IV
– Rapid Eye Movement (REM)
Sleep Disorders Parasomnias
somna
sleeo
nightmares
bruxism
enuresis
eat
Somnambulism (sleep walking)
–Sleep terrors
Nightmares
Bruxism (teeth grinding)
Enuresis (bed-wetting)
Sleep-related eating disorde
Sleep Disorders Dyssomnias
insomnia
hypersomnia
narcolspesy
Insomnia-trouble falling, staying or getting good sleep
Hypersomnia-excessive sleepiness-sleep longer then normal at night or daytime sleepiness
Narcolepsy-sleep disorder that daytime sleepiness
Sleep disorder Sleep Apnea
Obstructive Sleep Apnea (OSA
occurs when your breathing is interrupted during sleep, for longer than 10 seconds at least 5 times per hour
- Sleep Disorders Other
Restless Leg Syndrome
- Sleep Deprivation
hrs of sleep per age
infant
toddler
preschooler
school age
teenager
adult
infant-12-15
toddler-11-14
preschooler-11-13
school age(6-11)-9-11
teenager-8-10
adult-7-9
sleep assessment
Sleep History
Health History
Physical Exam
Sleep Diary
Diagnostic Studies
– Polysomnography
– EEG
*Nursing Interventions sleep
“Preparing a Restful Environment”
Sleep hygiene
Bedtime rituals
Create a restful environment
Promote comfort and relaxation
Education about rest and sleep
– Hospital setting:
Minimize disturbances
Use of meds to promote sleep
Sleep Medications
Sedative-Hypnotic
Benzodiazepine/non-BZD
– zolpidem
Anti-Anxiety
Anti-Depressants
Antihistamines
– doxepin
Melatonin
– ramelteon
PHYSIOLOGY OF MOVEMENT AND ALIGNMENT
skeletal
muscular
nervous
Skeletal System… framework of bones, joints between them, and cartilage
Muscular System… composed of 3 types of muscles
*Skeletal
*Cardiac
*Smooth/Visceral
Nervous System… allows skeletal and muscular system to function
NORMAL MOVEMENT AND ALIGNMENT
Body Alignment or Posture
Balance
Coordinated Body Movement
Postural Reflexes
EXERCISE-muscle contraction
istonic
isometric
isokinetic
isotonic-same tension-weight on muscles stays same-involve rom- aerobic activities like walking swimming
Isometric-same length-a muscle contraction without changing length-planks wall sits
Isokinetic-speed remains constant,but resistance varies-uses exercise machines-used after injury to regain strength
EXERCISE body movements
Aerobic-hr and oxygen-running
Stretching
Strength/Endurance
Movement & ADLS
NURSING INTERVENTIONS movements
Promoting Exercise…AROM / PROM
Encouraging independence with ADL’s
Assisting with ambulation / movement
- Safe transfers
BENEFITS OF EXERCISE
Cardiovascular
Respiratory
Musculoskeletal
Metabolic/Endocrine
GI
GU
Skin
Psychosocial
EFFECTS OF IMMOBILITY
Cardiovascular
Respiratory
Musculoskeletal
Metabolic
GI
GU
Skin
Psychosocial
Nursing Assessment oxygenation
Physical Assessment Respiratory/Cardiac/Integumentary
CRT
Vitals
Labs
Medications
Health History
Current
Cough? Productive?
Dyspnea? Fever? Fatigue?
Factors Affecting Cardiopulmonary
Functioning and Oxygenation
Level of health
Acute and Chronic illnesses
Obstructed airway
Developmental considerations
Medication
Lifestyle
Environmental
Psychological
Diagnostic Testso2
ECG-record of cardiac activity
capnography- carbon dioxide levels in expired gas
thoracentesis- Procedure to aspirate pleural fluid, air, or both
Diagnostic Tests (Pulmonary)
Pulmonary Function Tests
Incentive Spirometry
Peak Flow Meter
Pulse Oximetry
Promoting Optimal Functioning oxygenation
Healthy Lifestyle
Vaccinations
Reducing Anxiety
Good Nutrition
Fluid Intake
Humidified Air
Promoting Proper Breathing
Incentive Spirometer
Pursed Lip Breathing
Chest Physiotherapy
- Medications
Expectorants
Suppressants
Antihistamines
Nebulizers & Inhaler
Promoting Oxygenation
supplemental
artifical
mechanical
Supplemental Oxygen
CPAP/BiPAP
Artificial Airway
Endotracheal vs. Tracheostomy
Mechanical Ventilation
Chest Tubes
Pleural Effusions
Pneumothorax
What is Cultural Diversity?
Coexistence of different ethnic, biological sex, racial, and socioeconomic groups
Religion
Language
Physical Size
Sexual Orientation
Age
Disability
Occupational Status
Geographical Location
Why is Cultural Diversity Important?
Provides improved provider-patient communication
Lack of understanding may cause inconsistency in care
discrimination
limits access to care
prevents health care team members from providing quality care
Cultural Definitions
bias
sterotyping
prejudice
ethnocentrism
assimillation
Bias-unfair prejudice in favor of or against one thing
Stereotyping-to believe unfairly that all people or things with a particular characteristic are the same
Prejudice-preconceived opinion that is not based on reason or actual experience.
Ethnocentrism-evaluation of other cultures according to preconceptions originating in the standards and customs of one’s own culture.
Cultural Assimilation (acculturation)–when immigrant groups are encouraged to “adopt the culture, values, and social behaviors of their host nation
Cultural Competence
Be aware of your own culture
Be accepting and respectful of cultural differences
Be understanding of the patient’s culture, health-related needs, and the meaning of health and illness
Be able to adapt care to be congruent with the patient’s culture
Be open and comfortable with cultural encounters
*Communication Style
Verbal Communication
Translator
Interpreter
“Cultural Broker”
Non-Verbal Communication
Touching
Eye contact
Space orientation
Time orientation
Nutritional patterns
Common Healthcare Concerns among Various Populations
asain
muslim
adventist
hispanic
Jehovah witness
Asian
Respect, Emotional Self-Control, Balance (Yin “cold”/Yang “Hot”)
Muslim
Fasting, Prayer, Modesty, Pork and Alcohol are prohibited
Adventist
Holistic approach to health, Narcotics/Stimulants are prohibited
Hispanic
Family, Catholic beliefs
Jehovah’s Witness
Alcohol/tobacco is discouraged, blood transfusions are prohibited
types of loss
actual
perceives
anticiptory
actual loss-can be recognized by others
perceived loss-intangible loss, unrecognized by others
anticipatory loss-yet to take place
grief
Internal emotional reaction to loss due to separation or death. May express physical, emotional, social, or spiritual grief
dysfunctional grief
Abnormal or distorted grief. May be unresolved or inhibited. May have troubles expressing their feelings of loss or deny them. Extends over a lengthy period
mourning
Outward expressions of grief. Actions or expressions of grief, including symbols and ceremonies
bereavement
State of grieving due to the loss of a loved one
Stages of Grieving
Kubler-Ross
Denial
Anger
Bargaining
Depression
Acceptance
Factors Affecting Grief Response
Age/ Developmental
Culture and religion
Gender
Socioeconomic
Support systems
Cause of death
Signs/Symptoms of Dying
Irregular Heart Rate
Resp (Cheyne -Stokes)
Decreased Input & Output
Decreased LOC
Decreased Temperature & Blood Pressure
Increased Restlessness
Mottling
Cyanosis
Incontinence
Signs/Symptoms of Death
Absence of Respirations, BP and Pulse
No response to stimuli
Absence of reflexes
end of life care
Actively listen- being fully
‘present’
Therapeutic communication (make sure to consider culture)
Touch
Comforting actions
Music
Massage
Privacy
Hospice Care
Promotes quality of life instead of treatment
Life-expectancy of 6 month or less to live
Comfort care
Reduce Stress
Symptoms relief related to serious illness
Physical and psychosocial relief
Palliative Care
Occurs at the same time as
curative treatment
Any stage of the disease
Comfort care
Reduce Stress
Symptoms relief related to serious illness
Physical and psychosocial relief
Care for body, mind, spirit, heart and soul
Legalities Related to Death & Dying
Advanced Directives
Living Will
Durable Power of Attorney
Voluntary Cessation of Eating/Drinking
Do Not Resuscitate (DNR)
Active/Passive Euthanasia
Death Certificate/Autopsy
Post-Mortem
Care
Rigor mortis
Usually occurs 4 hours
after death
Muscle stiffness/contraction
Care of body & family
Organ donation
Funeral Home
adventist
beliefs
select practices (no/saturday/approach)
believe in persons choice/body is temple
no narcotics/stimulants
Saturday is sabbath
approach to healthcare is holistic
muslim
beliefs
select practices(obtain/prayer/no/hygiene/faitful)
Koran is sacred
obtain health care from black community
prayer rituals
no pork or alcohol
hygiene
faithful marriages
buddhism
beliefs
select practices(looks/accepts/no/check)
buddha and 4 noble truths-human suffering is due to craving
looks to buddha for answers
accepts modern science
no taking lives
check if any diet restrictions
bahai
beliefs
select practices(seek/prayers/no)
Belive in science and religion
seek out competent medical care and pray for health
prayers/holy days/19 day fasts
no sterilization or abortions
Christian scientist
beliefs
select practices(declines/no/practictioner/no)
all illness is due to human mind-no meds
declines meds
no hypnotism or therapy
practionor may be called
no alchohol or tobacco
mormons
beliefs
select practices(avoid/Joseph/3)
many do not seek medical therapy
avoid coffee and tea
Joseph smith saw god
3 months of food on hand
confucianism
beliefs
select practices(appreciates/emphasized)
appreciation of life and desire to keep body from untimely to unnecasry death
apprecaites life
emphasized public health solutions to impending health problems
doaism
beliefs
select practices(knowing/long)
health is manifestation of harmony of universe
knowing and living a natural life is secret to health and sagehood
long tradition of seeking medical techniques
hinduism
beliefs
select practices(medicine/diets/avoid/cremation)
moral factors linked to karma
medicine open to new idea
diets are individual
avoid the lips
cremation
islam
beliefs
select practices(obligatory/koran/women)
allah is all powerful
obligatory prayers/ holy days/fasting/almsigivng
koran law influence everything
some women not allowed to make decisions
jehovhas witness
beliefs
select practices(no/no/courts)
opposition to false teachings including medicine
no blood tranfusions
no alcohol or tobacco
courts do not supports parents refusing lifesaving treatment for kids
judaism
beliefs
select practices (treatment special)
formation to god.hebrew bible
treatment should not be schedules on sabbath
special needs in areas od diet, birth,male female contact and death
native Americans
beliefs
select practices–rituals, medicine,theraputic
no real generalization-death is beginning of new life
rituals mark impooratn life changes, birth,puberty, iniation, death
medicine men and women have special spirits
Theraputic measures-sucking,blowing,feather pen.
Protestantism
beliefs
select practices(religious /sacraments/modern)
worship god but take modern medical stance
religious practices vary
sacreaments-baptism,communion and confirmation
roman catholic
beliefs
select practices(mass/seven/diet/sexual/natural)
worship god
mass on Sunday
seven sacramanets
dietary habits
sexual ethnicity norms
natural ways of birth-no abortion or sterilazion
Sikhism
beliefs
select practices(Kesh/kara/removing/sexual/same)
creating new world order based on equality and social justice for all
Kesh-uncut hair for all
Kara-steel handle worn on wrist
removing turban without permission is insult
sexual activity only with marraige
same sex doctor and nurse
unitarian
beliefs
select practices
encourage creativity reason and living to an ethical life
free to accept what is best for Their health
