Set 6 Flashcards
Short-term pain with a new or sudden onset; vital signs will be impacted
Acute pain (ex: appendicitis)
Pain that has persisted longer than 3 months that the body has learned to adapt to; may not impact vital signs
Chronic pain
Pain caused by injury to a tissue
Nociceptive pain
How do patients typically describe nociceptive pain?
Aching; throbbing
Pain caused by injury to the nerves
Neuropathic
How do patients typically describe neuropathic pain?
Burning, shooting, pins and needles
Pain with unknown origin
Idiopathic pain
T or F: the patient is the ONLY person who can administer analgesia via PCA
TRUE
The natural wake and sleep cycle of the human body
Circadian rhythm
Stage 1 through 3 of the circadian rhythm are going from _________ to _________ sleep
Light; deeper
A patients vitals signs are lowest during which stage of sleep?
Stage 3
How long after falling asleep do people enter REM?
90 mins
Characteristics of REM sleep
- difficulty to waking (also stage 3)
- vitals signs go up
- vivid dreaming
Sleep disorder characterized by difficulty falling asleep, staying asleep, or both
Insomnia
Sleep disorder characterized by excessive daytime sleepiness and inadvertently falling asleep while awake
Narcolepsy
Sleep disorder characterized by a stop in breathing for a period of time during sleep
Sleep apnea
Sleep hygiene patient education
- maintain regular sleep schedule
- sleep in a cool, dark, and quiet environment
- avoid afternoon naps
- avoid alcohol and caffeine later in the day
- exercise regularly, but NOT within 3 hours of bedtime
The physiological changes that happen during periods of stress
General Adaptation Syndrome (GAS)
Stages of GAS
Alarm, Resistance, Exhaustion
Fight or flight response of GAS (increased HR, BP, cortisol)
Alarm
Phase of GAS in which body begins to get used to stress, vital signs, and hormones might normalize BUT may have poor concentration, irritability, and frustration
Resistance
Phase of GAS in which the body cannot keep up with stress anymore and will have fatigue, depression, anxiety, and impaired immunity/disease
Exhaustion
5 Stages of Grief
Denial, Anger, Bargaining, Depression, Acceptance
A loss that an individual has not yet experienced, but is impending
Anticipatory grief
Grief that an individual feels on average, usually for 6-12 months, that resolves and do not impair ability to function
Normal/uncomplicated grief
Grief that persists for longer than one year and interferes with the ability to function
Complicated grief
A loss or grief that is not publicly acknowledged (“suffering in silence”)
Disenfranchised grief (ex: miscarriage; death of extramarital lover)
Care aimed at reducing/managing a patient’s pain or symptoms of a disease or illness ALONG with having curative treatment
Palliative care
Goal of palliative care
Increased quality of life and decreasing suffering (can be for patients who are or are not terminally ill)
Symptom management for life-limiting illness, typically for individuals who have a diagnosis of terminal illness with an estimation of less than 6 months to live
Hospice care
T or F: patient’s in hospice care are all DNR status
FALSE; you do not have to be DNR in hospice
Effects of immobility of the respiratory system
Decreased lung expansion and increased risk of atelectasis
Effects of immobility on cardiovascular system
Increased risk of blood clots
Effects of immobility on musculoskeletal system
Muscle atrophy and bone demineralization (increased risk for fractures)
Effects of immobility on gastrointestinal system
Decreased GI motility (increased risk for constipation)
Effects of immobility on renal system
Risk for kidney stones, UTIs
Effects of immobility on integumentary system
Risk for pressure injuries
Clotting of blood in a deep vein
Deep Vein Thrombosis (DVT)
DVTs most commonly occur in the
Calf and thigh
S/S of DVT
Erythema at site, edema, extreme pain at site
Pain on leg affect by DVT inflicted by raising the toes to nose while standing
Positive Howman’s sign
DVT patient education
- elevated leg, but NO pillows beneath the knee
- NEVER massage affected area (risk for dislodgement and PE)
- warm, moist compresses for pain
The nurse should alert the provider should a patient with a DVT develop
Sudden onset chest pain, SOB, decreased pulse ox, elevated HR (all signs of PE — MEDICAL EMERGENCY!)
What are the three things that promote lung expansion and airflow in an immobile patient?
Coughing, deep breathing, incentive spirometry
Compression stockings that help with blood return from the legs
TED hose
Compression device that squeeze the leg every now and then to help move blood back from the legs
Sequential Compression Devices (SCDs)
Pharmacological prevention of DVTs
Subq Lovenox (low molecular weight heparin)
Nursing care to combat effects of immobility
- reposition patient every two hours
- encourage ROM
- increase fiber and fluid
