Quiz #6 Sleep/Pain/Skin/MSK/Immobility/Leadership

Question 1

Cyclical process that alternates with longer periods of wakefulness:

Answer 1

sleep

Question 2

Influences the pattern of major biological and behavioral functions:

Answer 2

Circadian rhythm

Question 3

Synchronizes sleep cycles

Answer 3

Biological clock

Question 4

Sleep that progresses through four stages (light to deep), contributes to body tissue restoration:

Answer 4

NREM

Biological functions slow. HR falls to 60 or less/min.

Question 5

Rapid eye movement (REM) phase at the end of each sleep cycle:

Answer 5

REM

Question 6

More vivid and elaborate during during REM sleep and are functionally important to learning:

Answer 6

Dreams

Question 7

Urination during the night, which disrupts the sleep cycle:

Answer 7

Nocturia

Question 8

Inadequacies in either the quantity or quality of nighttime sleep:

Answer 8

Hypersomnolence

Question 9

Involves the use of electroencephalogram (EEG), electromyogram (EMG), and electrooculogram (EOG) to monitor stages of sleep:

Answer 9

Polysomnogram

Question 10

Most common sleep complaint, signaling an underlying physical or psychological disorder:

Answer 10

Insomnia

Question 11

Practices that patience associates with sleep:

Answer 11

Sleep hygiene

Question 12

Characterized by the lack of airflow through the nose and mouth for 10 seconds or longer during sleep:

Answer 12

Sleep apnea

Question 13

EDS, results in impaired waking function, poor work performance, accidents, and emotional problems:

Answer 13

Excessive Daytime Sleepiness

Question 14

Dysfunction of mechanisms that regulate the sleep and wake states (excessive daytime sleepiness:

Answer 14

Narcolepsy

Question 15

Sudden muscle weakness during intense emotions at any time during the day:

Answer 15

Cataplexy

Question 16

Problem patients experience as a result of dyssomnia:

Answer 16

Sleep deprivation

Question 17

More common in children, an example is sudden infant death syndrome:

Answer 17

Parasomnnias

Question 18

Primary function is unclear, it contributes to physiological and psychological restoration:

Answer 18

sleep

Question 19

7 factors that a nurse should consider before delegating a nursing intervention:

Answer 19

• Condition of the patient (acuity)
• Scope of practice (person to deleage to may not have the required ability)
• Safety (potential for harm [to yourself or to patient])
• Level of interaction required for the patient (trust, communication skills, knowing what type of question to ask the patient)
• Capabilities of the CNA: some are not as skilled as others
• Availability of competent staff to delegate to

Question 20

How to delegate the right task:

Answer 20

Has to be something ABLE to delegate… can also change with circumstances. Ex: unstable patient, would not delegate vitals.

Question 21

The right circumstance to delegate:

Answer 21

Can not be something the nurse has to do… looks at all factors… patient history, staff availability…

Question 22

The right person to delegate to:

Answer 22

They have to be qualified to do the task, be able to do the task, and be able to trust them to do it right.

Question 23

The right direction/communication to delegate:

Answer 23

Directions need to be clear and concise.
Ex: “I need you to count the number of respirations for one minute and tell me the number” versus “I need you to go count his/her respirations”

Question 24

Right supervision for delegation:

Answer 24

We have to make sure that it’s done right. Compare info to patient’s chart to see if “off”.

We are ultimately responsible.

Question 25

What we call the role of influencing people, giving them direction, a purpose, and commitment challenges:

Answer 25

leadership

Question 26

4 Types of leadership:

Answer 26

1) Authoritarian: Very controlling “It’s done MY way.”
2) Democratic: Things are done OUR way. Everyone has a say and they work together to accomplish goal.
3) Laissey-Faire: “I don’t care how you do it, just get it done”. Sometimes things don’t get done and if it does may not be done well… there’s no direction. Some things will be missed… may not have a good outcome of goal.
4) Bureaucratic: Bunch of red tape. There is always something getting in the way… another hoop to have to jump through… a lot of rules/regs. A lot may hinder the goal.

Question 27

Generate from the breakdown of phospholipids in cell membranes… thought to increase sensitivity to pain:

Answer 27

Prostaglandins

Question 28

Released from plasma that leaks from surrounding blood vessels at the site of tissue injury:

Answer 28

Bradykinin

Binds to receptors on peripheral nerves, increasing pain stimuli.

Binds to cells that cause the chain reaction producing prostaglandins.

Question 29

Found in pain neurons of dorsal horn (excitatory peptide), needed to transmit pain impulses from periphery to higher brain centers:

Answer 29

Substance P

Causes vasodilation and edema.

Question 30

Produced by mast cells causing capillary dilation and increased capillary permeability:

Answer 30

Histamine

Question 31

Released from the brainstem and dorsal horn to inhibit pain transmission:

Answer 31

Serotonin

Question 32

The natural supply of morphinelike substances in the body:

Answer 32

Neuromodulators (Inhibitory)

Activated by stress and pain.

Located within the brain, spinal cord, and GI tract.

Cause analgesia when they attach to opiate receptors in the brain.

Present in higher levels in people who have less pain than others with a similar injury.

Question 33

Converts energy produced by thermal, chemical, or mechanical stimuli into electrical energy:

Answer 33

Transduction

Begins in the periphery by pain-stimulus, sends impulse across nociceptor initiating an action potential.

Question 34

Once transduction is complete, this begins:

Answer 34

Transmission

The neurotransmitters either excite during transmission or inhibit during modulation.

The cellular damage caused by thermal, mechanical, or chemical stimuli results in the release of excitatory neurotransmitters such as prostaglandins, bradykinin, substance P, and histamine.

The excitatory neurotransmitters are pain-sensitizing substances that surround the pain fibers in the extracellular fluid and spread the pain message causing an inflammatory response.

Pain stimulus enters the spinal cord via the dorsal horn

Question 35

Melzack and Wall’s theory from 1965, was the first to suggest that pain has emotional and cognitive components in addition to physical sensations:

Answer 35

Gate-Control Theory of Pain

Gating mechanisms located along the CNS regulate or block pain impulses.

Pain impulses pass through when a gate is open and are block when closed.

Closing the gate is the basis for nonpharmacological pain-relief interventions.

Factors such as stress and exercise increase the release of endorphins, often raising an individual’s pain threshold.

Question 36

4 physiological processes of normal pain:

Answer 36

1. Transduction
2. Transmission
3. Perception
4. Modulation

Question 37

The point at which a person is aware of pain:

Answer 37

Perception