Rest (sleep), Aging, & Death Flashcards
Patients w/ depression are often associated w/ which of the follow sleep disorders (insomnia, narcolepsy, obstructive sleep apnea, & restless leg syndrome)
Insomnia
Identify this key term:
- rhythm that completes a full cycle every 24 hours
Circadian Rhythm (diurnal rhythm)
What is a natural chemical produced at night that decreases wakefulness and promotes sleep by regulating circadian rhythm
Melatonin
What is the condition in which patients are unable to lie still and report experiencing unpleasant creeping, crawling, or tingling sensations in the legs
Restless Legs Syndrome (RLS):
What stages are “light sleep” and take up b/w 5-50% of sleep.
Stage I and II
What stages of sleep are “deep-sleep” states and take up 10% of sleep.
Stages III and IV
Which stage of sleep does “delta sleep” occur in?
Stage III and IV
What happens to
Pulse, RR, BP, Temperature, metabolic rate, skeletal muscle tone and deep tendon reflexes during REM sleep?
Increase in Pulse, RR, BP, Temperature, metabolic rate
Decrease in skeletal muscle tone and deep tendon reflexes
Describe the order of a sleep cycle.
Wakefulness ⇢ Stage I ⇢ II ⇢ III ⇢ IV ⇢ III ⇢ II ⇢ REM ⇢ II ⇢ III ⇢ IV ⇢ III ⇢ II ⇢ REM
Stage I becomes replaced by REM
What is the general pattern of recommended hours of sleep as you age?
It decreases
What age is considered middle ages?
What ages are considered old age?
What is the range for the 3 subclasses of old age?
- middle: 40 to 65 years old
- old age: 65+
- Young old: 65-75
- Middle: 75-85
- Old old: 85+
What visual acuity changes are possibly seen in middle adult?
presbyopia
(A gradual, age-related loss of the eyes’ ability to focus actively on nearby objects.)
What auditory acuity diminishes in middle age?
High-pitched or Low-pitched sounds?
High-pitched
(e.g., woman’s voice, bird chirp, child’s squeal)
Is cognitive function decreased in middle ages?
Why might it take slightly longer for middle age adults to respond?
No, response times may be longer due to a longer search through more memories and to a desire to think a problem through before responding.
What are leading causes of death in middle adult hood?
(3/6)
- Malignant neoplasms (cancer)
- Cardiovascular disease
- Unintentional injury including poisoning, motor vehicle accidents, and falls
- Diabetes mellitus
- Chronic lower respiratory disease (e.g., COPD, emphysema, bronchitis, & asthma)
- Cerebrovascular (blood flow to the brain) causes (e.g., stroke)
What are major health problems for middle adults?
- Rheumatoid arthritis
- Obesity
- Alcoholism
- Depression
What changes occur in short and long-term memory for Older Adults?
Mild short-term memory loss is common
(can be remedied by notes, reminders, calendars, etc)
Long-term memory is intact
What are the causes of accidental Injuries in Older Adults.
(Name: 3/7)
consider physiological changes
- Changes in vision and hearing
- Loss of mass and strength of muscles
- Slower reflexes and reaction time
- Decreased sensory ability
- Combined effects of chronic illness and medications
- Economic factors
- Falls are the most common cause of injuries and hospital admission in older adults
___ is a series of adverse events triggered by an initial medical or nursing intervention initiating a downward decline.
Cascade iatrogenesis
Swallowing difficulty can lead to ___.
aspiration
risk of fractures are increased in which gender?
What time in their lives is this further increased?
Females (due to loss of calcium in bones)
Post-menopause
What type of loss is described?
“can be recognized by others as well as by the person sustaining the loss”
e.g., loss of a limb, a child, a valued object such as money, and a job.
Actual Loss
What type of loss is described?
“is felt by person but intangible to others”
e.g., loss of financial independence, youth, social standing
Perceived loss
What type of loss is described?
occurs when a person displays loss and grief behaviors for a loss that has yet to take place
e.g., awaiting passing of a family member
Anticipatory loss
What characteristic may be a normal finding with an older adults toenails?
Become thicker and yellowish tint to the nails beds
Exposure to the sun over the years can cause a patient’s skin to be more ___.
Pigmented
your skin increases its production of the brown pigment called melanin to protect itself from the damaging effects of the sun.
What happens to the bladder capacity of older adults?
↓ capacity = ↑ voiding (urination)
What is the most common degenerative neurological illness and cause of cognitive impairment in older adults?
Alzheimer disease
Which problem is described commonly seen in patients with dementia?
“an older adult habitually becomes confused, restless, and agitated after dark”
sundowning syndrome
What are two types of advance directives?
- Living will
- Durable healthcare power of attorney or proxy.
What code is this?
Medical order, no CPR in event that heart or breathing stops
sometimes called No Code or Allow Natural Death (AND)
DNR (Do Not Resuscitate)
What is being described?
“indicates that the goal of treatment is a comfortable, dignified death and that further life-sustaining measures are no longer indicated.”
Comfort Care Only
What is terminal weaning?
Withdrawal from mechanical ventilation
What is the difference between active and passive euthanasia?
Active euthanasia is actively inducing death in a patient.
Passive euthanasia is not doing anything (withdrawing medical treatment) to cause death.
Placing the body in the correct anatomical position should be done post-mortem for what reason?
Important to begin soon after death to avoid contractures due to rigor mortis.
The circadian biological clock is regulated by?
Suprachiasmatic Nucleus (SCN), a group of cells within the hypothalamus
Which sleep disorder is often associated with cataplexy?
How long can it last for?
Narcolepsy
seconds to 2 minutes
sudden loss of muscle tone while a person is awake leads to weakness and a loss of voluntary muscle control.
Cataplexy
Once a persons narcolepsy has ceased due to medications, what would be the next step for the medications?
Continue on, d/c would lead to relapse in narcolepsy
Methylphenidate, Modafinil
are you to treat which sleep disorder?
Narcolepsy
What vital sign changes do we see during obstructive sleep apnea (OSA)?
What are the long term effects of OSA
- ↑ HR & BP, ↓ SpO2
- Can lead to CV disease (heart is working harder trying to get adequate oxygen)
- Fatigue
- Depression
