MODULE 7: COGNITIVE, SENSORY, PAIN, AND SLEEP Flashcards
WHAT ARE 3 PARTS OF THE NEUROLOGICAL SYSTEM
- cognitive function
- intellectual function
- sensory function
WHATS SOME SUBJECTIVE DATA RELATED TO COGNITIVE FUNCTION
- Common concerns or injuries (symptoms)
- past medical history
- social determinants of health (lifestyle. behavioural, enviornmental)
- age related changes (delerium, dementia)
WHATS SOME OBJECTIVE DATA RELATED TO COGNITIVE FUNCTION
- level of conciousness
- oritentation
- glascow coma scale
- behaviour and appearance
- language ( read simple sentences, point to an object and name it, responding to simple verbal commands)
WHAT ARE THE 3 THINGS WE TEST FOR ON THE GLASCOW COMA SCALE
- eye opening response
- verbal response
- motor response
WHATS SOME OBJECTIVE DATA RELATED TO INTELLECTUAL FUNCTION
- memory: recent, immediate, past
- knowledge
- abstract thinking
- association
- judgement
WHATS SOME SUBJECTIVE DATA RELATED TO INTELECTUAL FUNCTION
” how clearly are you thinking today”
WHAT ARE SOME CHARACTERISTICS OF DELERIUM
- ACUTE disturbance of attention and awareness and change in cognition
- confusion, disorientation, restlessnes
- often reversed when correctly assessed and underlying cause is resolved
- may occur in older patients but occasionally younger
- often misdiagnosed as a form of dementia
WHAT ARE SOME CHARACTERISTICS OF DEMENTIA
- gradual, irreversible, more progressive
- loss of memory, judgement, and reasoning
- often mistaken with delerium
WHAT ARE THE 4 THINGS TESTED IN THE SCHMID FALL ASSESSMENT TOOL. AT WHAT SCORE IS A PATIENT AT RISK FOR FALLS?
mobility, mentation, elimination prior fall history
Score >3 is risk for falls.
WHAT IS SENSORY DEPRIVATION AND SENSORY OVERLOAD
- sensory deprivation: inadequate quality or quantityof stimulation due to lack of sensory stimuli in environment (or can’t interpret it)
- sensory overload: when a person receives multiple sensory stimuli and cannot disregard and ignore it
WHAT IS SOME SUBJECTIVE DATA RELATED TO SENSORY FUNCTION
- sensory alterations history
- use of assistive devices
- ability to perform self care
- health promotion habits
WHATS SOME OBJECTIVE DATA RELATED TO SENSORY FUNCTION
- Mental status
- physical assessment ( vision, hearing, tactile testing)
- use of assistive devices
- ability to perform self care
- environmental hazards
HOW WOULD YOU TEST DERMATOMES
- eyes closed and bilaterally
WHAT ARE SOME NURSING INTERVENTIONS RELATED TO SENSORY FUNCTION
HINT 7
- safety
- adaptions for vision loss (tripping hazards)
- adaptations for reduced hearing (closed captioning, lip reading)
- adaptations for reduced taste (oral hygeine)
- adaptations for tactile sensation (therpeutic touch, encourage independence)
- adaptations for environment (reorienting)
- promote self care
WHAT IS PAIN?
it is a personal experience and it is beyond a neurological response, it can affect psychological, functional, and social well being and theres many ways to express it (varies within culture)
WHAT IS THE PHYSIOLOGY OF PAIN
- transduction: tissue cell damaged, inflammatory substances released
- transmission: spreads pain message to dorsal horn and relays it to higher brain centers
- perception: conciousness of pain
- modulation: increase or decreased intensity, involved neurotransmitters
WHAT ARE THE IMPACTS/ FACTORS OF PAIN
physical, spiritual, psycholgical, social
WHAT ARE SOME EXAMPLES OF SYMPATHETIC OR PARASYMPATHETIC STIMULATIONS FOR PAIN
SYMPATHETIC: increased HR, BP, respirations, diaphoresis, Bloof glucose, and decreased gastric motility
PARASYMPATHETIC: pallor, muscle tension, decreased HR and BP, irregular breathing and weakness
WHAT ARE THE TYPES OF PAIN
- persistent post-op pain
- inferred pathology process
- breakthrough
- cancer
WHAT ARE SOME CHARACTERISTICS OF ACUTE PAIN
- less than 3 months
- predictable ending and identifiable cause
- usually resolves without treatment after damaged area heals
- unreleived acute pain can have negative impact on recovery
WHAT ARE SOME CHARACTERISTICS OF CHRONIC PAIN
- longer than 3 months
- associated with actual or potential tissue damage
- chronic paon can be intermittent or persistent
- may be concurrent with other symptoms
- pharmalogical and non pharmalogical strategies should be used
WHAT ARE THE PARTS OF THE PAIN ASSESSMENT (OPQRSTUV)
- onset
- palliation/provocation
-quality
-region
-severity
-timing
-understanding
-value
WHAT ARE SOME BEHAVIOURAL AND NON-VERBAL INDICATORS OF PAIN
- vocalizations (moaning, groaning)
- facial expressions (grimacing)
- body movements (restless, protective)
- social interactions (avoidant)
WHAT ARE SOME NON-PHARMALOGICAL INTERVENTIONS FOR ADDRESSING PAIN
- collaboration and positioning
- relaxation and guided imagery
- distraction
- music
- reducing pain perception
- massage
cutaneous stimulation, acupuncture, and therapeutic touch (reiki) need additional training
