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Clinical > 💉- Sleep & Palliative Care Test > Flashcards

💉- Sleep & Palliative Care Test Flashcards

1
Q

Leptin

A

Is decreased during sleep deprivation

Tells you to stop eating

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2
Q

RAS

A

Reticular activating system

Regulates sleep and wakefulness

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3
Q

NREM stage I

A
  • polysomnography (sleep readings)
  • can be awakened without difficulty
  • if aroused, may feel as if hasn’t slept
  • dreams usually not remembered
  • lasts 5-10 mins
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4
Q

NREM stage II

A
  • Light sleep ; polysomnographic readings show intermittent peaks and valleys
  • ❤️rate slows, decrease body temp
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5
Q

NREM stage III

A
  • deep sleep ; aka slow wave or delta sleep
  • if aroused during this stage, may feel disoriented for a few minutes
  • snoring and sleep walking may occur
  • important for restorative processes such as healing, growth and tissue renewal
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6
Q

REM sleep

A
  • usually occurs 90 mins after sleep onset
  • final R.E.M. Stage may last up to an hour ; first one lasts typically 10mins
  • increased ❤️rate, temp, BP, metal and gi secretions
  • spontaneous awakenings
  • essential for mental and emotional restoration
  • intense dreaming occurs
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7
Q

Rebound R.E.M.

A

A person deprived of R.E.M. Sleep for several nights will usually spend greater amount of time in the R.E.M. Sleep on successive nights

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8
Q

Dyssomnia

A

Characterized by insomnia or excessive sleepiness

Ex: insomnia , circadian disorders, sleep apnea, RLS, hypersomnia, narcolepsy

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9
Q

Parasomnia

A

Patterns of waking that appear during sleep

Ex: sleep walking/talking, bruxism, night terrors, R.E.M. Sleep behavior disorder, nocturnal enuresis

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10
Q

Bruxism

A

Grinding and clenching of the teeth, usually occurs during stage II NREM sleep

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11
Q

Circadian disorders

A

Abnormality in sleep/wake times

Ex: jet lag, working night shift, rotating shifts

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12
Q

What is an associated cause of RLS

A

Low iron levels

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13
Q

Night terrors vs Nightmares

A

Night terrors occur during NREM (deep sleep)

Nightmares occur during R.E.M. (Dream)

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14
Q

Secondary sleep disorders

A

Occur when disease process alters sleep stages or quantity/quality of sleep

Ex: depression, hyper/hypothyroidism, pain, airway passage obstruction and CNS dysfunction

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15
Q

Sleep provoked disorders

A

Because of the disease presences , person gets worse as they sleep

Ex: CAD, asthma, COPD, diabetes, gastric ulcers, epilepsy

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16
Q

What is an appropriate bedtime snack

A

Complex carb (bread, cereal) + protein (milk, cheese)

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17
Q

Tryptophan

A

An amino acid found in turkey , promotes sleep

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18
Q

Perioperative nursing

A

Involves patient care before, during and after surgery

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19
Q

AORN and TJC established patient safety goals

A

Prevent infection

Improve accuracy of patient identification

Increase patients involvement of care

Perform a time out before starting procedures

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20
Q

NEVER events

A

Medicare will no longer reimburse institutions for care related to these complications

Ex: surgery on wrong body part, wrong person, wrong surgery, VTE after knee or hip replacement, foreign body left in patient after surgery, surgical site infections after certain elective procedures

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21
Q

What are the 4 ways to classify surgeries

A

By body system

Purpose

Level of urgency

Acuity

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22
Q

Ablative surgery

A

Removal of a diseased body part

Ex: a cholecystectomy removes a diseased gallbladder

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23
Q

Diagnostic (exploratory) surgery

A

Confirm or rule out a diagnosis

Ex: biopsy, fine-needle aspiration, invasive testing such as a cardiac catherization

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24
Q

Palliative surgery

A

Alleviate discomfort or other disease symptoms without producing a cure

Ex: nerve root destruction for chronic pain

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25
Reconstructive surgery
Restore function Ex: rotator cuff repair
26
Transplant surgery
Replaces a malfunctioning body part, tissue or organ Ex: also includes joint replacements
27
Emergency surgery
Requires transport to OR as quickly as possible to preserve the patients life or function Causes: internal hemorrhage, rupture of an organ and trauma
28
Urgent surgery
Is scheduled within 24-48 hours to alleviate symptoms, repair a body part or restore function Ex: removal of a cancerous breast and internal fixation of a fracture
29
Elective surgery
Performed when surgery is the recommended course of action, but the condition is not time sensitive Ex: repair of a torn ligament, removal of rectal polyps or rhinoplasty (repair of the nose)
30
Who is responsible for obtaining informed consent for the surgical procedure
The surgeon is responsible for 1. Giving the patient the necessary info and 2. Determining the patients competence to make an informed decision about the surgery
31
What is the nurses responsibility in reference to informed consent
Verifying that the surgical consent form is signed and witnessed
32
What is included in the pre-operative checklist
Vitals, assessment, chart components, MAR, valuables, family
33
Sterile team
Includes the surgeon, RNFA, surgical tech, scrub nurse
34
What are the duties of the scrub nurse or surgical tech
Sets up sterile field, prepares surgical instruments, assists with sterile draping, responds to needs of surgeons and maintains sterile field
35
What does the sterile field encompass
The client and area immediately surrounding the client, waist or table up
36
Clean team
Abide by clean technique (medical asepsis) include the anesthesiologist or nurse anesthetist, circulating RN, biomedical tech, radiology tech *should never enter the sterile field
37
Circulating nurse
Is a RN who applies the nursing process to coordinate all activities in the operating room
38
General anesthesia
Produces rapid unconsciousness and loss of sensation
39
Conscious sedation
Is an alternative form of anesthesia that provides IV sedation and analgesia without producing unconsciousness Ex: bronchoscopy And cosmetic surgery
40
Regional anesthesia
Prevents pain by interrupting nerve impulses to and from the area of the procedure - the patient remains alert but is numb in the involved area Ex: minor ambulatory procedures
41
Spinal anesthesia
Is the injection of an anesthetic into the cerebrospinal fluid in the subarachnoid space - this injection blocks sensation and movement below the level of the injection Ex: surgical procedures in lower abdomen, pelvis and lower extremities
42
Epidural anesthesia
Requires insertion of a thin catheter into the epidural space - anesthetic agents are infused through the catheter to produce loss of sensation
43
Local anesthesia
Produces loss of pain sensation at the desired site Ex: a wound to be sutured or skin growth removal Can be applied topically or injected
44
Who positions the client for surgery
The circulating nurse. Being mindful of - high risk for pressure ulcers, shearing of tissue and padding bony prominences
45
What are the 5 variables to consider while positioning a patient for surgery
Access to surgical site Access to patients airway Need to monitor vital signs Comfort Safety
46
What things are included in the TIME OUT (final check)
Right patient Right procedure Right site
47
What are the 5 responsibilities of the circulating nurse
Time out Monitor Sterile field Monitor I&O Sponge, sharps and instruments count Documentation
48
Responsibilities of postoperative nurse
Initial QUICK focused assessment of patient in presence of anesthesia Vital signs every 5-15 minutes Airway management Dressing assessment/drainage Fluid therapy Aldrete Recovery Scale
49
Actual vs perceived loss
Actual - can be identified by others; not just the person experiencing it (ex: death, theft, destruction) Perceived - is internal; only identified by the person experiencing it
50
Physical vs psychological loss
Physical - includes injury (amputated limb), removal of an organ, loss of function (immobility) Psychological - commonly seen in the areas of sexuality, control, fairness, meaning and trust
51
External bs internal loss
External - actual losses of objects that are important to the person b/c of sentimental value (ex: jewelry, a home) Internal - is another name for perceived or psychological loss
52
Loss of aspects of self
Include physical losses such as body organs or limbs , developmental change (aging process), loss of hopes and dreams and faith
53
Environmental loss
Involves a change in the familiar; even if the change is positive Ex: new home, new job
54
What is grief , mourning and bereavement
Grief - physical, psychological and spiritual responses to a loss Mourning - action associated with grief (ex: crying) Bereavement - mourning and adjustment time following a loss
55
Uncomplicated grief
(Normal grief) Is the natural response to a loss
56
Complicated grief
Aka prolonged acute grief Is characterized by its length of time and intensity of emotion - responses last longer than 6 months and maladaptive Ex: bereaved may become depressed, violent or suicidal etc
57
Chronic grief
A type of complicated grief - begins as normal grief but continues long term, with little resolution of feelings and inability to rejoin normal life
58
Masked grief
Occurs when the person is grieving, but expressing the grief through other types of behavior Ex: a man whose wife died may begin drinking heavily
59
Delayed grief
Is grief that is put off until a later time
60
Disenfranchised grief
Is experienced in connection with a loss that is not socially supported or acknowledged by the usual rites or ceremonies Ex: miscarriage, termination of foster placement, mistress whose lover dies
61
Anticipatory grief
Is experienced before a loss occurs
62
Uniform determination of death act
Provides a highly reliable means of declaring death for respirator-maintained bodies; loss of brain stem function
63
What are the 5 stages of dying
``` Denial Anger Bargaining Depression Acceptance ```
64
Palliative care vs hospice care
Palliative - holistic comfort care Hospice - holistic care of patients who are dying or debilitated and not expected to improve
65
List 4 nursing interventions involving loss , grief and dying
Therapeutic communication Facilitating grief work Helping families Specific activities involved in care of the dying person
66
What are the 3 components of facilitating grief
Expressing feelings Recalling memories Finding meaning
67
Gravely disabled client
The gravely disabled or threat to yourself or others can be held involuntary
68
Conditional release
Requires outpatient treatment for specified period
69
Unconditional release
Discharge or termination of client-institution relationship
70
What are the 5 clients rights related to mental health
Right to treatment Right to refuse treatment Right to informed consent: based on right to self-determination Freedom from restraint Confidentiality
71
Gherlin
Is increased during sleep deprivation Tells you when you're hungry

Clinical (12 decks)

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