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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
Q

Reconstructive surgery

A

Restore function

Ex: rotator cuff repair

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26
Q

Transplant surgery

A

Replaces a malfunctioning body part, tissue or organ

Ex: also includes joint replacements

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27
Q

Emergency surgery

A

Requires transport to OR as quickly as possible to preserve the patients life or function

Causes: internal hemorrhage, rupture of an organ and trauma

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28
Q

Urgent surgery

A

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

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29
Q

Elective surgery

A

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
Q

Who is responsible for obtaining informed consent for the surgical procedure

A

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
Q

What is the nurses responsibility in reference to informed consent

A

Verifying that the surgical consent form is signed and witnessed

32
Q

What is included in the pre-operative checklist

A

Vitals, assessment, chart components, MAR, valuables, family

33
Q

Sterile team

A

Includes the surgeon, RNFA, surgical tech, scrub nurse

34
Q

What are the duties of the scrub nurse or surgical tech

A

Sets up sterile field, prepares surgical instruments, assists with sterile draping, responds to needs of surgeons and maintains sterile field

35
Q

What does the sterile field encompass

A

The client and area immediately surrounding the client, waist or table up

36
Q

Clean team

A

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
Q

Circulating nurse

A

Is a RN who applies the nursing process to coordinate all activities in the operating room

38
Q

General anesthesia

A

Produces rapid unconsciousness and loss of sensation

39
Q

Conscious sedation

A

Is an alternative form of anesthesia that provides IV sedation and analgesia without producing unconsciousness

Ex: bronchoscopy And cosmetic surgery

40
Q

Regional anesthesia

A

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
Q

Spinal anesthesia

A

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
Q

Epidural anesthesia

A

Requires insertion of a thin catheter into the epidural space - anesthetic agents are infused through the catheter to produce loss of sensation

43
Q

Local anesthesia

A

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
Q

Who positions the client for surgery

A

The circulating nurse. Being mindful of - high risk for pressure ulcers, shearing of tissue and padding bony prominences

45
Q

What are the 5 variables to consider while positioning a patient for surgery

A

Access to surgical site

Access to patients airway

Need to monitor vital signs

Comfort

Safety

46
Q

What things are included in the TIME OUT (final check)

A

Right patient
Right procedure
Right site

47
Q

What are the 5 responsibilities of the circulating nurse

A

Time out

Monitor Sterile field

Monitor I&O

Sponge, sharps and instruments count

Documentation

48
Q

Responsibilities of postoperative nurse

A

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
Q

Actual vs perceived loss

A

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
Q

Physical vs psychological loss

A

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
Q

External bs internal loss

A

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
Q

Loss of aspects of self

A

Include physical losses such as body organs or limbs , developmental change (aging process), loss of hopes and dreams and faith

53
Q

Environmental loss

A

Involves a change in the familiar; even if the change is positive

Ex: new home, new job

54
Q

What is grief , mourning and bereavement

A

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
Q

Uncomplicated grief

A

(Normal grief)

Is the natural response to a loss

56
Q

Complicated grief

A

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
Q

Chronic grief

A

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
Q

Masked grief

A

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
Q

Delayed grief

A

Is grief that is put off until a later time

60
Q

Disenfranchised grief

A

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
Q

Anticipatory grief

A

Is experienced before a loss occurs

62
Q

Uniform determination of death act

A

Provides a highly reliable means of declaring death for respirator-maintained bodies; loss of brain stem function

63
Q

What are the 5 stages of dying

A 
Denial
Anger
Bargaining 
Depression 
Acceptance
64
Q

Palliative care vs hospice care

A

Palliative - holistic comfort care

Hospice - holistic care of patients who are dying or debilitated and not expected to improve

65
Q

List 4 nursing interventions involving loss , grief and dying

A

Therapeutic communication

Facilitating grief work

Helping families

Specific activities involved in care of the dying person

66
Q

What are the 3 components of facilitating grief

A

Expressing feelings

Recalling memories

Finding meaning

67
Q

Gravely disabled client

A

The gravely disabled or threat to yourself or others can be held involuntary

68
Q

Conditional release

A

Requires outpatient treatment for specified period

69
Q

Unconditional release

A

Discharge or termination of client-institution relationship

70
Q

What are the 5 clients rights related to mental health

A

Right to treatment

Right to refuse treatment

Right to informed consent: based on right to self-determination

Freedom from restraint

Confidentiality

71
Q

Gherlin

A

Is increased during sleep deprivation

Tells you when you’re hungry

Clinical (12 decks)

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