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Exam 4 > exam 2 > Flashcards

exam 2 Flashcards

1
Q

cessation or temporary interruption of motion, exertion, or labor.

A

rest

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2
Q

the natural periodic suspension of consciousness during which the powers of the body are restored.

A

sleep

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3
Q

what are the purposes of sleep and rest?

A
  1. Restoration and repair of the body
  2. Strengthening of the immune system
  3. Facilitates memory storage
    Improves learning
  4. Improves coping ability
  5. Maintenance of normal
    weight and processing
    of carbohydrates
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4
Q 
Take longer to fall asleep
Sleep arousal periods are longer and
more frequent
Disrupters of sleep – nocturia, pain
- more sleep required to feel rested
Stage IV may be absent or greatly reduced
A

older adult-65+

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5
Q

A daily cycle of biological activity based on a 24-
hour period
Regulated in the hypothalamus

A

circadian rhythm

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6
Q

sleep proved disorders include?

A
  • Coronary Artery Disease
  • Asthma
  • COPD
  • Diabetes Mellitus
  • Gastric and Intestinal Ulcers
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7
Q

sleep disorders characterized by a disturbance in the normal pattern or rhythm of sleep.

A

dyssomnias

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8
Q

sleep disorders characterized by undesirable motor, verbal, or experiential phenomenon.

A

parasomnias

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9
Q 
• Definition: A period cessation of breathing
during sleep
• Frequency: 5 to 30 times per hour
• Length: few seconds to minutes
• Types:
Obstructive: from airway obstruction
Central: dysfunction in the respiratory control
center of the brain
Mixed: Combo of the two above types
A

sleep apnea

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10
Q

the result of a prolonged sleep disturbance,
such as insomnia
• Can be NREM or REM deprivation
• Also a NANDA approved nursing diagnosis
• Signs and Symptoms:
• Prolonged: Delusions, Paranoia, Weakened Immune
System

A

sleep deprivation

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11
Q

excessive daytime sleeping
Causes: Usually caused by another sleep disorder
which prevents night-time sleeping, such as sleep
apnea or insomnia
May also be the result of another disorder –
kidney or liver disease, DM, depression
Treatments: find and treat the cause

A

hypersomnias

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12
Q

A disorder characterized by sudden and
uncontrollable attacks of deep sleep
• Narcoleptics can sleep well at night but frequently
have other sleep disorders as well
• Can also have cataplexy
• Each episode the patient falls immediately into REM
sleep and can have very vivid dreams
• Thought to be caused by an inability of the brain to
regulate the sleep and wake cycles
• Treatments: CNS stimulants, Safety interventions

A

narcolepsy

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13
Q

They are CNS depressants

A

Benzodiazepines

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14
Q

• Newest Class of Drugs for Sleep
• Target specific sleep receptors vs. entire CNS
system
• Shorter ½ life – Less chance of a ‘hangover’ effect
• Two different types…

A

hypnotics

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15
Q

arthritis, HTN, hearing impairments,
heart conditions, visual impairments, musculoskeletal
impairments, diabetes, chronic sinusitis, hay fever,
allergic rhinitis and varicose veins

A

10 most common conditions affecting those aged 65 and older

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16
Q

the scientific study of the aging process
focusing on determining answers about normal aging
processes

A

gerontology

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17
Q

the medical specialty dealing with diagnosis

and treatment of diseases affecting the elderly

A

geriatrics

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18
Q

applies the nursing process to older adults to achieve a level of wellness consistent with the limitations imposed by aging

A

gerontological nursing

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19
Q

Biological theories of aging include?

A
  • stochastic theories

* non-stochastic theories

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20
Q

aka Damage or Error theories

A

*stochastic theories

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21
Q

aka Programmed theories

A

*non-stochastic theories

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22
Q
  • Wear and Tear theory
  • Rate of Living theory
  • Cross-linking theory
  • Free Radicals theory
  • DNA Damage theory
A

stochastic theories

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23
Q
  • Programmed Longevity theory
  • Endocrine theory
  • Immunological theory
A

*non-stochastic theories

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24
Q

Normal aging changes include?

A
  • Perfusion
  • Oxygenation
  • Immunity
  • Mobility
  • Neural Regulation and Cognition
  • Nutrition
  • Elimination
  • Child bearing
  • Sensory perception
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25
Q 
DECREASED:
– Cardiac Output
– Vessel Elasticity
– Baroreceptor function
INCREASED:
– Blood pressure (>140/90)
– Peripheral Vascular Resistance
– Time for heart rate to return to
it’s resting rate
A

Perfusion

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26
Q 
Decreased :
– Lung Capacity
– Respiratory muscle strength and
flexibility
– # and Ability of Alveoli (Gas
Exchange)
– Cough reflex
Increased:
– Airway Resistance
– Risk of Infection
A

Oxygenation

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27
Q 
Decreased:
– Immune Response
Antibody Response
T-cell production
Increased:
– Risk of Autoimmune Disorders
– Risk of Cancers
What would this mean for our patients?
Increased susceptibility to infections
A

Immunity

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28
Q 
Decreased:
– Muscle mass and strength
– Bone Density and Strength
– Flexibility of the Joints
– Size of Vertebral discs
– Height
A

mobility

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29
Q 
Decreased:
– Size and # of Neurons
– Rate of Conduction
Reaction time, Reflexes
– Nerves/Sensation
– Rate of thinking
– Memory
– Attention Span and
Concentration
A

Neural Regulation and Cognition

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30
Q 
Decreased: 
– Saliva
– Sense of taste and smell
– Peristalsis and motility
– Gastric atrophy
– Gastric secretions
– Pancreatic enzymes
– Liver size and function
A

Nutrition

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31
Q 
Men: Prostate enlarges
Decreased :
– Nephrons (filtration)
– renal blood flow
– bladder tone and capacity
– Motility (risk for
constipation)
Increased:
• Risk of Incontinence
A

Elimination

32
Q 
Males
Decreased:
• Pubic hair
• Size of testicles
• Testosterone
• Sperm
production
• Ability to initiate
and maintain
erection
• Ejaculation
Females
Decreased:
• Pubic hair
• Estrogen
• Size of ovaries,
fallopian tubes,
breasts, and uterus
• Vaginal moisture &
flexibility
• Vaginal atrophy
A

child bearing

33
Q 
Decreased:
– Pupil size and reaction
Presbyopia (Accommodation)
Adjustment to light/dark
– Tear production
– Lens flexibility and clearness
Yellowing
Cataract
Color Discrimination
Increased:
– Sensitivity to glare
– Floaters
A

sensory perception: VISION

34
Q 
Decreased:
– Ability to Hear (Presbycusis)
Nerve cells
High Frequency
Discrimination
Increased:
• Eardrum thickens
• Excessive cerumen
A

sensory perception: hearing

35
Q 
Decreased:
• Nerve Cells
• Ability to feel temperature (heat/cold)
• Ability to feel pain
• Ability to determine body position in
space (Proprioception)
A

Sensory Perception

Touch

36
Q 
Decreased:
– Moisture
– Elasticity (wrinkles)
– Subcutaneous fat
– Epidermis
– Efficiency of sweat glands
– Peripheral vessel strength
– Hair
Senile Lentigines (age spots)
A

Infection Control Skin and Hair

37
Q

taking care of personal self:

washing. dressing, feeding, mobility, transferring, toileting

A

ADLs

38
Q

cooking, shopping, driving, etc activities

A

IADLs

39
Q

Unique medical conditions facing
the elderly. They are highly prevalent, multifactorial and
associated with increased morbidity and poorer outcomes

A

geriatric syndromes

40
Q

Types of urinary incontinence include:

A

–Functional
–Stress
–Urge/Hyperactive or Overactive Bladder
–Overflow

41
Q

Physical or cognitive problems cause an inability to perform normal toileting
*Voiding before reaching an appropriate receptacle

A

functional incontinence

42
Q

Involuntary leakage of urine due to increased abdominal pressure which can occur with exercise, laughing, coughing and sneezing. Weakened muscles, and abdominal pressure forces urine out
*Loss of urine with increased abdominal pressure

A

stress incontinence

43
Q

Passage of urine following a strong sense of the need to void commonly caused by bladder spasms or contractions. Can also occur with UTI or kidney stones
*Strong urges to void frequently also associated with frequency (every 2 hours)

A

urge/hyperactive or overactive bladder

44
Q

Leakage of urine without having sensed the need to void.

*Lack or urge to void and unawareness of bladder filling; loss of urine without cause (urge, stress)

A

overflow

45
Q

Behavioral treatment techniques for urinary incontinence include?

A
  • pelvic floor exercises
  • bladder retraining
  • scheduled toileting
46
Q

When done properly and regularly, these can build up
and strengthen the muscles of the pelvic floor. Instruct the patient to squeeze their pelvic muscles as if they are attempting to prevent the flow of urine

A
  1. Pelvic floor exercises (Kegels)
47
Q

Pelvic floor exercises (Kegels) consist of?

A
  • biofeedback

* electrical stimulation

48
Q

Sensors can be attached to a person to record which muscles are being used for pelvic floor exercises. If the person is doing them incorrectly by using the wrong muscles this will be recorded by the sensors conversely, the person will learn when they are using the correct muscles and therefore doing the exercises correctly.

A

biofeedback

49
Q

stimulation to the pelvic floor muscles to elicit contraction, used as physical therapy retraining of those muscles. Frequently used in combination with biofeedback and pelvic floor exercises

A

electrical stimulation

50
Q

Patients should start by keeping a diary of how often they void. Based on their current voiding pattern an interval of time is selected which is reasonable for that patient between voids. Patients are to void at that interval of time and gradually increase the interval between voiding. This will increase bladder capacity and increase control. Multiple distraction techniques can be taught when the urge happens before it is time to void

A

bladder retraining

51
Q

the patient is taken to void on a specific schedule, such as every 2 hours.

A

scheduled toileting

52
Q

suppress involuntary bladder contractions and spasms and may increase bladder capacity. Examples: tolterodine (Detrol), oxybutynin (Ditropan), solifenacin (Vesicare), darifenacin (Enablex). Side effect: dry mouth

A

Antispasmodics (Anticholinergics/Antimuscarinic agents)

53
Q

anticholinergic and sedative effects so may help with bladder contractions and spasms. Examples: imipramine (Tofranil). Side effect: urinary retention

A

Tricyclic antidepressants

54
Q

These are small tampon-like disponsable devices or plugs that are inserted into the urethra to prevent leakage of urine. They can be used for women with predictable incontinence such as during activities which would cause stress incontinence. The device would be placed prior to the activity, such as dancing, and then removed to urinate

A

urethral inserts

55
Q

This is a stiff ring that is inserted into the vagina and worn daily. It assists with holding the bladder up in correct placement and is helpful with incontinence due to a prolapsed bladder or uterus.

A

pessary

56
Q

The Impress Softpatch (UroMed Corporation, Needham, Mass.) is a hydrogel adhesive patch designed for single use and is placed over the urethral meatus. The FemAssist (Insight Medical Corporation, Boston, Mass.) and CapSure Shield (Bard Urological, Covington, Ga.) are silicon devices placed over the urethral meatus similar to a suction cup. known to significantly decrease urine loss

A

patch or shield

57
Q

different types of surgery include?

A
  • Bladder neck suspension
  • Periurethral bulking therapy
  • Pubovaginal sling
  • Artificial urinary sphincter
58
Q
  • Temporary
  • Acute Onset
  • Potentially Reversible
  • Find the cause – fix the problem
  • pt can be returned to baseline
A

delirium

59
Q
  • Permanent
  • Gradual Onset
  • Irreversible
  • Patient’s with Dementia can also get Delirium!!
  • Includes Alzheimer’s disease and vascular dementia
A

dementia

60
Q

types of elder abuse include?

A 
• Types:
Physical
Emotional
Sexual
Exploitation
Neglect
Abandonment
61
Q 
increases the risk of elder
abuse BUT IS NOT THE SINGLE CAUSATIVE
FACTOR FOR ELDER ABUSE !
• Risk Factors:
Poor relationship prior to need for caregiving
Abuse of elder to caregiver prior to the need for
caregiving
Need for control by the caregiver
Greed
A

caregiver stress

62
Q

what are the 2017 national patient safety goals?

A
  1. Identify patients correctly
  2. Improve staff communication
  3. Use medicines safely
  4. Use alarms safely
  5. Prevent infection
  6. Identify patient safety risks
  7. Prevent mistakes in surgery
63
Q 
 Equipment-related Errors
 Fires and Other Electrical
Hazards
 Mercury Exposure
 Biological Hazards
A

safety risks related to healthcare facility

64
Q 
 Restraints
 Medication Errors
 Improper Use of
Equipment
 Procedure-related Errors
 “Never-Events”
A

safety risks related to procedure error

65
Q

what are a list of never events?

A
  1. Stage III and IV Pressure Ulcers
  2. Falls and Trauma
  3. Surgical Site Infection
  4. Vascular-catheter Associated Infection
  5. Catheter Associated UTI
  6. Administration of Incompatible Blood
  7. Air Embolism
  8. Foreign Object Unintentionally Retained after
    Surgery
66
Q

 Back Injuries
 Needlestick Injuries
 Radiation Exposure
 Violence

A

hazards to healthcare workers

67
Q

what does the acronym race stands for?

A

R=Remove
A=Activate
C=Confine
E=Extinguish

68
Q

to control aggressive/violent behavior or behavior

that is dangerous to self or others.

A

behavioral restraint

69
Q

to control a patient’s inability to respond to direct

requests or follow specific instructions or a patient’s direct attempts to remove vital catheters, tubes and lines.

A

physical restraint

70
Q

what needs to be assessed with a pt that has restraints?

A
  • Vital Signs
  • Circulatory Status
  • Respiratory Status
  • Mobility
  • Skin Integrity
  • Continued Need for Restraints
71
Q

A physical order for restraints needs to be renew?

A

every 24 hours

72
Q

A behavioral order for restraints needs to be renewed?

A

Every: 4 hour for adults
2 hours for adolescents
1 hours for children

73
Q

A physical MD eval for restraints needs to be renewed

A

every 24 hours

74
Q

A behavioral MD eval for restraints needs to be renewed?

A

Every 8 hours for adults

Every 4 hours for non-adult

75
Q

Nursing restraint assessment for a physical restraint is?

A

every 2 hours

76
Q

Nursing restraint assessment for a behavioral restraint is

A

Every 15 minutes

Exam 4 (7 decks)

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