Nur 152 exam 2

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Rem sleep

90 min after sleep begins 20 min approx. dreams

Management of dyspnea

Morphine Bronchodilators Sedatives Diuretics Oxygen

Rhonchi

Mucous

Non opioid analgesic

NSAIDs Tylenol ibuprofen

Upper airway

Nasopharynx orpharynx

Psychogenic pain

No pathological condition can be found.

Chronic episodic pain

Sporadically over extended period of time Episodes last for hours days or weeks Ex: sickle cell crisis

Nrem sleep

Stage 1 light sleep Stage 2 10-20 min sound sleep Stage 3 15-30 min deep sleep vital sighs decrease Stage 4 deepest sleep 15-30 min

Cutaneous

Sunburn papercut

Cough suppressant

Suppresses cough

Perfusion

The circulation and delivery of oxygenated blood to the body

Right lung

Three lobes

Left lung

Two lobes

Stages of normal sleep

Two- nrem and rem

Narcolepsy

Uncontrollable urge to sleep

Situational loss

Unexpected car accidents not prepared loss of a job

Restless leg syndrome

Urge to move legs. Cause unknown.

Passive euthanasia

Withdrawing medical tx with intention of causing death

Ras

Reticular activating system

Senses

Sight Hearing Taste Touch Smell

Mottling

Skin color changes

Parasomnias

Sleep walking, sleep terrors Hallucinations, eating disorders, enuresis (bed wetting)

Phantom limb pain

A type of neuropathic pain. Itching or burning.

Visceral

Abdominal pain gi issues premenstrual pain

Types of pain

Acute Chronic Chronic episodic Cancer

Cancer pain

Acute or chronic May be at tumor site or referred

Inspiration

Air in

Pharmacological measures for relief of pain

Analgesics- non opioid, opioids or narcotics, adjuvant drugs

Cultures

Before antibiotics started

Tx for osteoporosis

Calcium and vitamin d

Necessary loss

Can be replaced new teachers etc

Orthopnea

Can't sleep laying flat

Mallows hierarchy and rest

Cannot t move up without sleep

Maturational loss

Children growing up

Expiration

Co 2 out

Atelectasis

Collapsed lung

Neuropathic pain

Complex and chronic Tingling Diabetics No warning signs to withdraw from pain

Carina

Cough reflex

Aphasia

Damage to speech center of the brain

Symptoms of apnea

Daytime drowsiness Hypertension Headaches Depression Angina

Delayed grief

Delayed or postponed

Kubler Ross theory of grief and dying

Denial Anger Bargaining Depression Acceptance

Dyspnea

Difficulty breathing

Active euthanasia

Direct action causing death. Assisted suicide.

Non pharmalogical relief measures

Distraction, humor, music, imagery, acupuncture, hypnosis etc

Complications of immobility

Dvts, respiratory issues, osteoporosis, atrophy, contractures, increase Utis, gi issues, skin breakdown, psychosocial

Normal grief

Emotions gradually diminish

Radiating pain

Extends to nearby tissues

Crackles

Fluid in alveoli

Pleural effusion

Fluid in between pleura lining

Somatic

Fractures plantar fasciitis

Respirations

Gas exchange

Opioids

Hydro codons, oxycodone, morphine

Pharmalogic therapy for sleep disorders

Hypnotics first class not physically addictive (ambien, lunesta) Benzos 2nd line addictive( zanex, Valium, Ativan)

Pharmacological tx for insomnia

Hypnotics- ambien, lunesta short term

Sensory overload

Icu patients

Palliative care

Improves quality not quantity not life

Insomnia

Inability to fall or stay asleep

Hypoxemia

Inadequate oxygen in blood

Adjuvant drugs

Increase the efficacy of other drugs Ex: anti depressants benzos muscle relaxants

Masked grief

Ineffective grief resolution

Nociceptive pain

Injured body tissue Trauma or surgery Aching throbbing

Xerostomia

Lack of taste

Anticipatory grief

Letting go of an object before loss

Chronic pain

Longer than 6 months No identifiable cause

Expectorant

Loosens secretions

Compliance

Loss of elasticity in lungs

Actual loss

Loss of limb person pet

Perceived loss

Loss of youth financial status

Disenfranchised grief

Loss that seems of lesser significance

Death

Lungs and heart cease to function

Hours before death

Mental clarity Cheyn stokes respirations Dehydration Gag reflex declines Death rattle

Pulmonary vein and artery

Opposite of other veins and arteries

Death and dying dignity act

Oregon Washington Vermont

Referred pain

Pain felt in part of the body considerably removed from origin. Example: mi pain in arm, gallbladder in shoulder, appendix in belly button

Cheyn stokes respirations

Periods of apnea

Sleep apnea

Periods of not breathing during sleep

Pulmonary edema

Pink and frothy sputum

complicated grief

Prolonged difficulty moving forward

Epiglottis

Protects against aspiration

Acute pain

Rapid onset, identifiable cause

Sensory perception

Requires in tact nervous system


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