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Nursing Semester 2 > Monica - week14 - Exam 5 > Flashcards

Monica - week14 - Exam 5 Flashcards

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1
Q

what is insomnia?

A

inability to fall asleep or remain asleep

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2
Q

insomnia may be associated with ____??

A

anxiety d/t lack of restful sleep

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3
Q

what is short term insomnia caused by?

A

attributed to unresolved daily conflicts like stress

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4
Q

what is considered “long term” insomnia?

A

lasting 30 days or longer

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5
Q

what is long term insomnia caused by?

A

depression, manic disorders, or chronic pain

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6
Q

what is another factor for insomnia?

A

restless sleep pattern

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7
Q

that are 6 factors that contribute to restless sleep pattern?

A
  • foods or beverages containing stimulants like caffeine
  • tobacco products
  • alcohol (helps fall asleep but not restful sleep)
  • large meal close to bedtime (↑ metabolic rate/really full)
  • too much light or uncomfortable room temperature
  • snoring or recurring nightmares
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8
Q

what are 7 non pharm interventions to promote sleep?

A
  • lower or avoid caffeine
  • smoking cessation
  • limit or no alcohol intake
  • increase exercise during the day
  • establish sleeping pattern
  • alternative and complementary therapies
  • pharmacotherapy if interferes with ADLs
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9
Q

name 8 alternative and complementary therapies

A

kava, valerian root, chamomile, and lavender

*others include counseling, yoga, aroma therapy, massage, acupuncture

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10
Q

what should be assessed when using alt. and comp. therapies?

A

assess for contraindications with other drugs (chamomile)

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11
Q

what is the definition of anxiety?

A

worry, apprehension, fear, or uneasiness over a perceived threat

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12
Q

an anxiety response can last at least ________

A

6 months

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13
Q

what are 3 characteristics of anxiety?

A

o activates SNS and triggers symptoms of flight-or-fright
o may affect quality of life
o increased risk of GI and CV issues

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14
Q

what is obsessive compulsive disorder?

A

thoughts; obsess over same thoughts; occupy the mind for hrs/days

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15
Q

what is post traumatic stress disorder?

A

witnessed a traumatic event; keep on living experiences through nightmares hallucinations flashbacks

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16
Q

what is general anxiety disorder?

A

persists or at least 6 months; worry or fear; everyday life; inability to focus; impending doom

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17
Q

what is panic disorder?

A

similar to general anxiety disorder; what they fear most is having a panic attack that will cause them to freeze them from what they’re supposed to do

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18
Q

what is social anxiety disorder?

A

social phobia; reasonable persistent fear of being criticized; avoid public place and dont like people when they have to be social → great discomfort

19
Q

Stress related to ______ often a symptom of an ______ _____-

A

anxiety; underlying disorder

20
Q

non-pharmacological interventions r/t anxiety all have to do with addressing the _____ of the anxiety

A

cause

21
Q

what are 6 strategies to address the cause of anxiety?

A 
o cognitive-behavioral 
o counseling 
o biofeedback techniques- 
o meditation 
o herbal products
- pharmacotherapy if interferes with ADLs
22
Q

what are CNS depressants used for?

A

anxiety and sleep disorders

23
Q

what are the 2 categories for CNS depressants?

A

benzodiazepines and nonbenzodiazepines

24
Q

what are the effects of CNS depressants?

A

depression ranges from relaxation to sleep

25
Q

what are CNS depressants also known as?

A

sedatives and hypnotics

26
Q

what are the 3 characteristics that classify it as a sedative?

A

o relaxation, calmness, and ↓ anxiety
o lower doses
o taken during the day

27
Q

what are the 3 characteristics that classify it as a hypnotic?

A

o sleep
o induce sleep at higher doses
o taken at night

28
Q

what are the 3 characteristics of physical dependence?

A
  • altered physical condition d/t repeated substance use
  • body becomes accustomed to the abused substance
  • withdrawal symptoms when agent discontinued
29
Q

what are the 4 characteristics of psychological dependence?

A
  • no obvious physical signs of discomfort when agent is stopped
  • overwhelming desire to continue drug-seeking
  • high doses usually taken for a prolonged period
  • may persist for months or years
30
Q

what are the 2 forms of lorazepam?

A

IV and PO

31
Q

what is the main indication for lorazepam?

A

general anxiety disorder (anxiolytic)

32
Q

what are the off-label uses for lorazepam?

A

insomnia, seizures, alcohol, withdrawal sxs

33
Q

what is the action of lorazepam?

A

binds to GABA receptors and intensifies GABA effects

34
Q

what are the adverse effects for PO lorazepam? IV?

A

dizziness, daytime drowsiness, confusion, paradoxical
excitation
o IV – ↑ risk of respiratory depression

35
Q

what is the D-D interaction for lorazepam?

A

↑ CNS depression w/ other CNS depressants

36
Q

what is important to remember about stopping lorazepam?

A

slow tapering to avoid withdrawal sxs

37
Q

what is the antidote for lorazepam?

A

flumazenil

38
Q

what is temazepam used for?

A

short-term therapy of insomnia < 4 weeks

39
Q

what are 4 characteristics of temazepam?

A
  • possible risk of physical and/or psychological
    dependence
  • AEs similar to other benzodiazepines
  • may cause complex sleep-related behaviors
  • long half-life, more likely to cause daytime sedation
40
Q

what are the 2 non-benzo?

A

zolpidem (CR), eszopicione

41
Q

what are the indications for non-benzo?

A

o ↓ sleep-onset time and of nighttime awakenings
o improves the length and quality of sleep
o need 7-8 hrs. of sleep

42
Q

what is the action for non benzo?

A

binds to GABA receptors

43
Q

what are the adverse effects of non-benzo?

A

daytime drowsiness, dizziness, hallucinations, HA,
behavioral changes (sleep-driving), hangover
o eszopiclone – no frequent AES
o risk of rebound insomnia

44
Q

what are 8 geriatric considerations?

A
  • medication-related sleep problems
  • accumulates in the system
  • determine lowest effective dose
  • drugs may cause excessive drowsiness or dizziness – ↑ risk of falls and injury
  • safety precautions
    Home modifications:
    o remove throw rugs from walking areas
    o no doubling up on doses if first dose is ineffective

Nursing Semester 2 (21 decks)

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