Set 6

Question 1

Short-term pain with a new or sudden onset; vital signs will be impacted

Answer 1

Acute pain (ex: appendicitis)

Question 2

Pain that has persisted longer than 3 months that the body has learned to adapt to; may not impact vital signs

Answer 2

Chronic pain

Question 3

Pain caused by injury to a tissue

Answer 3

Nociceptive pain

Question 4

How do patients typically describe nociceptive pain?

Answer 4

Aching; throbbing

Question 5

Pain caused by injury to the nerves

Answer 5

Neuropathic

Question 6

How do patients typically describe neuropathic pain?

Answer 6

Burning, shooting, pins and needles

Question 7

Pain with unknown origin

Answer 7

Idiopathic pain

Question 8

T or F: the patient is the ONLY person who can administer analgesia via PCA

Answer 8

TRUE

Question 9

The natural wake and sleep cycle of the human body

Answer 9

Circadian rhythm

Question 10

Stage 1 through 3 of the circadian rhythm are going from _________ to _________ sleep

Answer 10

Light; deeper

Question 11

A patients vitals signs are lowest during which stage of sleep?

Answer 11

Stage 3

Question 12

How long after falling asleep do people enter REM?

Answer 12

90 mins

Question 13

Characteristics of REM sleep

Answer 13

• difficulty to waking (also stage 3)
• vitals signs go up
• vivid dreaming

Question 14

Sleep disorder characterized by difficulty falling asleep, staying asleep, or both

Answer 14

Insomnia

Question 15

Sleep disorder characterized by excessive daytime sleepiness and inadvertently falling asleep while awake

Answer 15

Narcolepsy

Question 16

Sleep disorder characterized by a stop in breathing for a period of time during sleep

Answer 16

Sleep apnea

Question 17

Sleep hygiene patient education

Answer 17

• 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

Question 18

The physiological changes that happen during periods of stress

Answer 18

General Adaptation Syndrome (GAS)

Question 19

Stages of GAS

Answer 19

Alarm, Resistance, Exhaustion

Question 20

Fight or flight response of GAS (increased HR, BP, cortisol)

Answer 20

Alarm

Question 21

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

Answer 21

Resistance

Question 22

Phase of GAS in which the body cannot keep up with stress anymore and will have fatigue, depression, anxiety, and impaired immunity/disease

Answer 22

Exhaustion

Question 23

5 Stages of Grief

Answer 23

Denial, Anger, Bargaining, Depression, Acceptance

Question 24

A loss that an individual has not yet experienced, but is impending

Answer 24

Anticipatory grief

Question 25

Grief that an individual feels on average, usually for 6-12 months, that resolves and do not impair ability to function

Answer 25

Normal/uncomplicated grief

Question 26

Grief that persists for longer than one year and interferes with the ability to function

Answer 26

Complicated grief

Question 27

A loss or grief that is not publicly acknowledged (“suffering in silence”)

Answer 27

Disenfranchised grief (ex: miscarriage; death of extramarital lover)

Question 28

Care aimed at reducing/managing a patient’s pain or symptoms of a disease or illness ALONG with having curative treatment

Answer 28

Palliative care

Question 29

Goal of palliative care

Answer 29

Increased quality of life and decreasing suffering (can be for patients who are or are not terminally ill)

Question 30

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

Answer 30

Hospice care

Question 31

T or F: patient’s in hospice care are all DNR status

Answer 31

FALSE; you do not have to be DNR in hospice

Question 32

Effects of immobility of the respiratory system

Answer 32

Decreased lung expansion and increased risk of atelectasis

Question 33

Effects of immobility on cardiovascular system

Answer 33

Increased risk of blood clots

Question 34

Effects of immobility on musculoskeletal system

Answer 34

Muscle atrophy and bone demineralization (increased risk for fractures)

Question 35

Effects of immobility on gastrointestinal system

Answer 35

Decreased GI motility (increased risk for constipation)

Question 36

Effects of immobility on renal system

Answer 36

Risk for kidney stones, UTIs

Question 37

Effects of immobility on integumentary system

Answer 37

Risk for pressure injuries

Question 38

Clotting of blood in a deep vein

Answer 38

Deep Vein Thrombosis (DVT)

Question 39

DVTs most commonly occur in the

Answer 39

Calf and thigh

Question 40

S/S of DVT

Answer 40

Erythema at site, edema, extreme pain at site

Question 41

Pain on leg affect by DVT inflicted by raising the toes to nose while standing

Answer 41

Positive Howman’s sign

Question 42

DVT patient education

Answer 42

- elevated leg, but NO pillows beneath the knee - NEVER massage affected area (risk for dislodgement and PE) - warm, moist compresses for pain

Question 43

The nurse should alert the provider should a patient with a DVT develop

Answer 43

Sudden onset chest pain, SOB, decreased pulse ox, elevated HR (all signs of PE — MEDICAL EMERGENCY!)

Question 44

What are the three things that promote lung expansion and airflow in an immobile patient?

Answer 44

Coughing, deep breathing, incentive spirometry

Question 45

Compression stockings that help with blood return from the legs

Answer 45

TED hose

Question 46

Compression device that squeeze the leg every now and then to help move blood back from the legs

Answer 46

Sequential Compression Devices (SCDs)

Question 47

Pharmacological prevention of DVTs

Answer 47

Subq Lovenox (low molecular weight heparin)

Question 48

Nursing care to combat effects of immobility

Answer 48

- reposition patient every two hours - encourage ROM - increase fiber and fluid