Week 3 Flashcards
1
Q
What is the procedure when stomach contents are removed to relieve stomach and intestines of pressure caused by the accumulation of air and fluid?
A
Gastric, decompression
2
Q
What is a nonmechanical functional obstruction of the test is caused by loss of bowel motility
A
Paralytic ileus 
3
Q
Lavage is contraindicated to remove blood, except when what?
A
In case of emergency
4
Q
What treatment is helpful when a patient has hyper or hypo thermia?
A
Gastric lavage
5
Q
When are large bore tubes used for?
A
Gastric, lavage, aspiration, and decompression
6
Q
When are orogastric tubes used?
A
In emergency departments and ICUs
7
Q
how long are orogastric tubes put in place for?
A
Enough to complete the lavage and evaluation of stomach contents
8
Q
What is the most common type of nasogastric tube?
A
Double lumen or two channel gastric sump tube
9
Q
What type of tube is most useful for decompressing, fluid and gas from the stomach?
A
The double lumen tube
10
Q
What is a major advantage of a gastric double lumen sump tube?
A
It can be used with continuous suction
11
Q
What are single lumen or Levin tubes used for?
A
Decompressing the stomach
Withdrawing specimens for diagnosis analysis
Washing the stomach free of toxic stuff, says other than poison
You’re getting the stomach to dispose and cheat upper G.I. bleeding in emergency
Administering feedings, and or medication’s
12
Q
What is a dual purpose tube used for?
A
Enteral feeding
Simultaneous gastric suction
Short term for clients are going surgery
13
Q
What is 3 lumen tube used for?
A
Gastric suction or drainage
Treating upper G.I. bleeding contraindications
14
Q
What are contraindications to NG tube placement?
A
Mid face trauma
Nasal surgery
Esophageal perforation
15
Q
Deviated, septum, esophageal, varices, recent Vandy, coagulation abnormalities are complications for what procedure?
A
Nasal gastric tubes 
16
Q
What position should you put a patient when inserting an NG tube perform?
A
High flowers to promote swallowing
17
Q
Where should you measure the tube for a nasogastric insertion?
A
From the ear to the xiphoid process and market tape, 20 to 30 cm 
18
Q
What pH of gastric secretions in between
A
One and five
19
Q
If a client does not have a gag reflex, what should the nurse do for a NG tube ?
A
Use water consciously or avoid it
20
Q
Why should the stomach not be auscultated while the NG tube is being placed?
A
It is not a reliable method because air can be heard over the stomach
21
Q
 What type of tube for compression has three lumens?
A
Sengstaten-Blakemore
22
Q
What type of tube for compression has 4 lm for esophageal suction to prevent aspiration?
A
Minnesota tube
23
Q
What type of tube for a compression is only used for gastric Pharisee treatment?
A
Linton-Nachlas tube
24
Q
When is a gastric lavage used for ingested toxins substances?
A
Hydrocarbon with a high aspiration potential
Poison
Corrosive substance with strong acid or alkaline
Absent airway, protective reflexes unless the client is intubated
25
When is activated charcoal administered?
Ingestion of multiple or unknown substances to treat poisoning or medication toxicity
26
What should be documented after a gastric lavage?
Date and time of gastric lavage
Type in volume of solution used
Type and size of tube used for the procedure
Client assessment
Volume color and consistency of gastric contents removed
Time asper it was sent to the laboratory
Client comfort
Education provided 
27
How much of 0.9% sodium chloride should be inserted into the NG tube to clear the tube of fluid?
10 mL
28
How much air should be injected into the nasogastric tube to clear the tube of fluid?
30 to 50 mL of air
29
What does keep your nose clean mean? 
Correct tube position
Stabilize tube
Evaluate nares
Alleviate pressure form the tube
Note date and time
Also change stabilizing device every 24 hours
30
What should I look for before I insert a nasogastric tube to ensure I don’t encounter difficulties
History of deviated septum
Nasal polyps
Nasal trauma
Surgery
Recent infection
31
What are some complications of a nasal intubation?
Pulmonary aspiration
Mucosal injury, and ulceration
Chronic irritation, causing rhinitis sinusitis pharyngitis
Fluid and electrolyte in balance
Acid base, imbalance, or metabolic alkalosis
32
When can an NG tube become dislodged?
When the tube is moved while coughing, and or clearing of the pharynx
33
How do I know if I have inserted a NG tube into the trachea?
The client will begin to cough and gag, and become cyanotic 
34
Which position should the nurse placed a client prior to beginning lavage to facilitate pulling, and removal of gastric contents?
Left lateral with head of the bed down about 15°
35
What time frame will provide the greatest benefit from gastric lavage following medication toxicity?
One hour
36
What kind of electrolyte imbalance can occur for an NG tube decompression for paralytic ileus? 
Hypokalemia or lower potassium
37
What NG tube can be used for continuous suction?
Salem sump tube
38
What is a Dobhoff tube used for?
Nasoduodenal feeding for clients with impaired wallowing or enteral feedings
39
How do you know if an NG tube connected to suction has become occluded?
The tubes cause increased abdominal distention 
40
Why should patients flex their heads through their chest after the tube passes through the nasal pharynx?
The action prohibits the tube from entering the trachea by closing it off an opening the esophagus
41
Long-term use of feeding tubes are called what?
Percutaneous endoscopic tubes
42
FOr adults what kind of nasal intestinal tube is used?
8 to 12 French tubes
43
What kind of tools is used for long-term therapy following?
Gastrostomy or jejunostomy tube
44
What are the four types of enteral formula?
Polymeric
Modular
Elemental
Specialty 
45
Which type of integral formula can be used with those who have the ability to absorb normal or whole nutrients
Polymeric formula
46
Which type of enteric formula provides single macro nutrients, and is used to supplement a clients nutrition?
Modular formulas
47
How much formula should a modular formula be given at a time?
3.8 to 4.0 kcal/milliliters.
48
What kind of Intero formula is good for people who has a partially dysfunctional gastrointestinal track to absorb nutrients?
Elemental formulas
49
Which kind of Antero formula is partially pre-digested?
Elemental formulas 
50
What is the purpose of specialty formulas?
Clients who have special nutritional needs and related to specific illnesses 
51
When is GI feeding tube care sterile?
Just after surgery
52
What are some ways to verify enteral tube verification?
Look for exit site marking
Aspirating fistic contents to measure PH
Measure it CO2 levels at the proximal end of the orzo gastric or nasogastric tub
53
What are a couple complications of enteral feeding?
Aspiration
Diarrhea
Psychosocial concerns
Skin breakdown 
54
How can a complication of diarrhea and enteral feedings be resolved?
Deliver, hyper osmolar formulas slowly
 Irritation, diluting the formula
Changing the formula type
55
What do absent vowel sounds indicate when feeding via tube?
Indicate increased ability of G.I. tract to digest or absorb nutrients
56
What is refeeding syndrome?
Clients who have been malnourished again to feed again, and the carbohydrates in the formula are being used for fuel rather than proteins stores 
57
What is an advantage of continuous feedings versus intermittent feedings?
Continuous feedings may decrease gastric residuals
Helps decrease of Domino discomfort
Intermittent feedings are preferred forecast for feedings
58
When are intermittent feedings preferred?
For gastric feedings
59
What can cause abdominal cramping after eight tube feeding
Hi osmolality of the formula
Too rapid infusion of tube feeding
Cold formula
Delayed gastric emptying
60
When is a small bore enteral feeding tube good for?
Short term feedings less than four weeks
61
Gastric residuals are to be checked every how often?
4 to 6 hours
62
How often should the feeding tube be flushed to prevent clogging?
Every four hours 
63
How long should a continuous enteral tube feeding be maximum?
No more than 12 hours optimally eight hours to reduce spoilage
64
If a client is at risk for aspiration, what kind of tube should be placed for feeding?
A nasal intestinal tube
65
What is the only reliable method for verifying initial placement of a small more feeding tube?
Obtaining an x-ray 
66
What is a quick and effective way to remove feces or flatus or to instill nutrients or medication
Enema
67
When is a regular bedpan used as opposed to a fracture bedpan?
Used for someone who can lift their hips up
68
When is it appropriate to use a fracture bedpan
When the clients cannot lift their hips up and have things like a body or like cast
69
How much should you lubricate a tube for an enema?
Two to three inches
70
How high should you hold the enema bag?
24 inches above the patient
71
How long should a patient generally hold an enema?
10-15 minutes or as long as tolerated
72
What are the types of fluids used for enemas?
Tap water
Normal saline
Soapsuds
Hypertonic solution
Carminative
Medicated
Oil 
73
What position should you place a client who is about to have an enema?
Sims or left lateral with right knee flexed which will adequately expose the anus
74
How deep should you put in an enema to for an adult and adolescent?
3 to 4 inches
75
How deep should you put an enema tube for a child?
2- 3 inches
76
How deep should you put in an enema tube for an infant?
1 to 1.5 inches
77
How does a cleansing enema work?
It stretches the bowel so that peristalsis is stimulated
78
What kind of solutions are used in a cleansing enema?
Topwater
Normal saline
Soap, suds solution 
79
How does the type of solution affect the electrolyte imbalance?
0.9% sodium chloride is an isotonic solution so it doesn’t pull electrolytes from the body or shift fluid side of the colon.
80
How long does a cleansing enema normally take effect?
10 to 15 minutes
81
How do soapsud enemas make you go?
It irritates the intestines
82
What kind of soap should a soapsud enema be used with?
100% pure Castile soap
83
When should a soap, side enema be used with caution?
When the client is pregnant or old, because it can lead to electrolyte, imbalance and damaged, intestinal mucosa
84
What is the correct mixture for a soapsuds enema?
1 L of solution to 5 mL of Castile soap 
85
Why should young infants and dehydrated clients avoid hypertonic solution enemas?
Hypertonic solutions, such as sodium phosphate, will pull fluid from the interstitial space to the colon
86
Infants and children should only receive saline enemas why?
It reduces the fluid and electrolyte imbalances that come with other enema fluids
87
How does an oil retention enema work to make you go?
It is absorbed by feces, making it softer and easier to pass 
88
How long should clients hold? Small volume cleansing enemas and oil retention enemas?
At least 30 minutes or as long as possible 
89
How long do small volume cleansing enemas and oil retention enemas take affect?
Within 5 to 10 minutes
90
When is a large-volume cleansing enema used?
Helps increase peristalsis and relieve flatus
91
What is the large volume guideline for an infant?
150 to 250 mL
92
What is a large volume cleansing enema, volume guideline for a toddler?
250 to 350 mL
93
What is the volume guideline for a child’s large, volume cleansing enema?
300 to 500 mL
94
What is the volume guideline for a large volume cleansing enema for an adolescent?
500 to 750 mL
95
What is the volume guideline for an adult when doing a large volume cleansing enema?
750 to 1000 mL 
96
How do medicated enemas work?
Antibiotics
Balance, electrolyte levels
Produce a systemic affect
97
What does an antibiotic neomycin do to the colon?
Reduce bacteria in the colon before surgery
98
What kind of medicated enema can be used to relieve flatus and abdominal distention?
carminative enemas with additives such as magnesium and glycerin
99
What are contraindications for enemas?
Increased intracranial pressure
Well,
Rectal or prostate surgery
100
How long should a client hold a cleansing enema?
5 to 15 minutes
101
How long should a patient hold a retention enema?
At least 30 minutes
102
Why should the enema solution be warmed before administering?
It reduces cramping
103
What kind of enema solution should be administered at room temperature?
Hypertonic and oil and retention enemas
104
How high should I raise the enema bag when administering a large volume cleansing enema?
No higher than 45 cm or 18 inches above the level of the anus
105
When can I delegate an enema to an LPN?
If the client’s vitals are stable and don’t require extra measures
106
What should I assess before I give a client an enema?
Elimination status
Last BM
pain
Ability to ambulate
Structural abnormalities
Sphincter control
107
What should I do if a client cannot retain the enema solution?
Reposition the client over the bed pan and dorsal recumbent
Hold the buttocks together for younger patients
108
What are some complications of enema administration?
Rigid or distended abdomen
Abdominal pain and cramping
Bleeding
109
What is the study of comparative measurement of the size, weight, and proportions of the human body
Anthropometry
110
What is an important indicator of nutritional status?
Unintended weight loss
111
What are the five major areas of nutritional assessment?
Anthropometry
History laboratory test
Dietary and health history
Clinical observation 
Client Expectations
112
What are some nutritional screening tools?
Height, weight, recent, weight change,
Client, primary diagnosis and presence of other factors
Subjective global assessment tool
Mini nutritional assessment tool
Malnutrition screening tool
113
What are some nursing assessment questions for nutrition?
Dietary intake and food preferences
Presence of unpleasant symptoms, such as indigestion or reflux
Difficulties with taste, chewing, or swallowing
Change in appetite or wait
Medication
114
Factors that influence nutrition
Environment
Developmental needs through the lifespan
Pregnancy
Lactation
115
What are some ways to check weight? (3)
Chair scale
Wheelchair scale
Sling or lift scale
116
What is a dangerous weight circumference for women?
35 inches
117
What is a dangerous weight circumference for men?
40 inches or more
118
Wha is a normal BMI?
18.5 to 24.9
119
A BMI greater than 35 puts the person at higher risk for what?
CHD, cancer
Diabetes mellitus
Hypertension
120
Why should you raise the head of the bed when assisting with feeding?
To reduce the potential of aspirating
121
What kinds of liquids are easier to swallow?
Thickened liquids
122
What are some adaptations that can help people maintain independence while eating?
Adaptive devices
Large handled or rounded handled utensils
Sipping cups
123
What are some signs to asses if the patient can eat independently post op?
Return of bowel function
Extent of operation
LOC
Complications from procedure
124
What happens if a person only receives standard intravenous fluid and nothing by mouth for more than 4 to 7 days?
They are at risk for malnutrition nutritional risk 
125
What are some ways to optimize the environment to encourage patience to eat?
Allowing adequate time to eat
Maintaining client comfort
126
What is the first thing to eat after NPO?
Clear liquid diet and then full later after
127
What is soft/low residue food?
Low fiver foods
Pastas
Casseroles
Moist tender meats
Canned cooked fruits and veggies
Desserts without nuts or coconut
128
What is a full liquid diet?
Clear liquids with dairy
Custards
Refined cooked cereals
Vegetable juice
Fruit juices
129
Modified fluid consistency diet examples are for who?
Those with dysphasia
130
What are examples of modified fluid consistency diets?
vegetable
Cream, soups
Tomato
Yogurt
131
What are the types of foods that are thicker than water but can be sipped through a straw?
Nectar consistency
132
What is it called when a food can be eaten with a spoon but do not hold or shape?
Honey consistency
133
What is the total average output for an adult?
2300 to 2600 mL a day 
134
What are items to measure when recording a client’s fluid intake?
Fluids
Tube feedings
Parenteral fluids
135
What fluids should be recorded that a client drinks?
Ice chips
Milk, coffee, tea, soft drinks
Sports drinks, or vitamin drinks
136
What kind of parenteral fluids should be recorded when measuring a clients fluid intake?
Blood products
Medication administered
Parenteral nutrition solutions
IV solutions
137
What are the items to measure when recording a clients fluid output?
Urine
Emesis
Liquid feces
All tube drainage
Wound drainage 
138
How Do you measure any incontinence pads or linens?
First way, the dry ones and then subtract the urine soaked items
139
How much should a carbohydrate account for in a diet?
45% to 65%
140
What are two fats that are not generated by the body?
Linoleum
Alpha-linoleic acids
141
What is it called when a food contains all nine amino acids?
Complete protein 
142
What percent should be the daily consumption of protein in a diet?
10 to 35%
143
Water is what percent of body fat?
50 to 75% of body mass
144
What are fat soluble vitamins?
D
A
K
E
145
What types of vitamins are toxic in excess amounts?
A
E
146
What are examples of water soluble vitamins?
B-complex vitamins
Vitamin C
Bioflavonoids
147
What are major minerals?
Calcium
Magnesium
Sodium
Potassium
Phosphorus
Sulfur
148
How much fluid does an infant need per day?
100 to 150 mL/kg
149
What happens if you give cows milk during their first year of life?
It can cause GI and renal problems
150
How many Kcals does a toddler need?
1,000 to 1,400 per day
151
What foods causes botulism toxin in infants?
Honey
Corn syrup
152
Why should toddlers be limited to a certain amount of milk?
Because too much can cause iron deficiency
153
What nutrient is important for clients planning or who are pregnant?
Iron and folic acid
154
What are some concerns that can increase the risk of nutritional deficiencies in those who are older than 65?
GI changes in text, gums and oral mucosa
Reduced income transporational challenges
Adverse effects of meds or comorbidites
Cognitive impairment
155
What are some changes to the gastrointestinal area for older adults that affect nutrition?
Alterations in the gums and teeth
Reduced saliva production
Atrophy of oral mucosa, epithelial cells
Decreased taste and thirst sensations
Reduce gag reflex
Decreased esophageal and colonic peristalsis 
156
When is a parenteral nutrition an option?
No functioning GI system
Critical illness
Major trauma
157
What is in a basic PN formula?
Crystaline amino
Hypertonic solution
Electrolytes
Vitamins
Trace elements 
158
When should you not use a TPN solution?
If you see oil droplets or creamy layer in the lipid layer
159
What does it mean if a patient with TPN administered gains weight more than 1 kg a day?
It means that there is fluid overload
160
What are some allergic responses to an adverse effect of TPN?
Elevated temp or sepsis
Elevated blood glucose levels
Shortness of breath and chest discomfort
Anemia and jaundice
Nausea and vomiting 
161
After how long should you discard unused TPN solution?
24 hours
162
Where can you find vitamin a?
Fish, liver oil’s, egg yolk, liver, fortified, milk, and margarine
163
What is vitamin a also called?
Retinol
164
What is vitamin a good for?
Vision skin, and mucous membranes integrity
Normal reproductive function
165
What vitamin is a steroid hormone and a precursor to cholecalciferol?
 Vitamin D
166
Which vitamin is an antioxidant?
Vitamin E
167
Which vitamin is found in vegetable oils, margarine, whole grains, and dark, leafy greens?
Vitamin E
168
What vitamin is required for forming clot proteins in the liver?
Vitamin K 
169
What nutrient is required for carbohydrate catabolism?
Biotin
170
What acid is good for steroid and hemoglobin synthesis metabolism of carbohydrates and fats and production of reproduction, hormones?
Pantone if acid
171
What nutrient plays a role in the health of integumentary, nervous and digestive systems
Niacin
172
What disorders does a fat restricted diet help alleviate?
Dyslipidemia
diabetes mellitus
cardiovascular disease
173
What sources of calcium are available for clients who are lactose intolerant?
Broccoli
Call Eric greens
Canned sardines and salmon
Molasses
Rhubarb
Soy flour
Spinach
Tofu
174
How does insoluble fiber help elimination of waste products and diabetics?
It decreases intestinal speed
Lowers blood cholesterol
Absorption of glucose
175
What is the clinical definition of anorexia?
Weight less than 85% of normal
Muscle wasting
Hypotension
Bradycardia
Hypothermia
Constipation
176
What body part is associated with vitamin C deficiency?
splinter hemorrhages
177
What does it mean if the hair is dry, dull and scarce?
It has a linoleic acid deficiency
178
What does it mean with a skin has flaky, dry patches?
Vitamin a B and linoleic acid deficiency
179
What does dry with soft corneas mean?
Vitamin a deficiency
180
What do swollen, puffy lips mean?
B complex deficiencies
181
What does a smooth appearance of the tongue mean?
Iron or B complex deficiencies
182
What does a swollen, beefy red tongue mean?
Vitamin B complex deficiencies
183
What is honey mouse hemianopsia?
Blindness in the same visual field of both eyes
184
What kind of vitamin helps bone fractures recover?
Vitamin C
185
How long should a patient remain in high fowlers after eating?
At least 60 minutes
186
What are expected albumin levels?
3.5 to 5.4 g/dL.
187
Why is albumin level airport short term indicator of proteins status?
it’s half life is 21 days so it is a better indicator of chronic illness not short term acute illness or nutritional status
188
How many milliliters in a fluid ounce?
30 mL
189
A 2 pound weight increase reflects how much increase of fluid?
1000 mL
190
What is the part of the brain responsible for regulation of circadian rhythm?
Suprachiasmatic nucleus in the hypothalamus
191
What gland produces melatonin?
Pineal gland
192
What is the function of the thalamus?
Process sensory info and regulate sleep
193
What two systems regulate the physiology of sleep?
Sleep-wake system
Circadian rhythm
194
What can affect the physiology of sleep?
Sleep deprivation
Lighting
Meds
Caffeine
Foods
Sleep environment
Stress
195
What might happen to a person with a damaged SCN?
They are not able to regulate their circadian rhythm during light-dark cycles
196
What produces GAB
Hypothalamus
197
What reduces the activity of the arousal centers?
GABA
198
What structure is responsible for transferring info from STM to LTM?
Thalamus
199
What is the function of the thalamus in sleep?
Block out external distractions and
200
What stage is the first stage of sleep and what is it also called?
Wake stage NREM
201
What waves does the NREM stage produce?
Alpha and beta waves
202
What waves has a frequency range of 8-12 hertz?
Alpha waves
203
What happens to breathing and muscle tone in NREM stage?
Normal
204
What is the lightest stage of sleep?
Stage one NREM
205
What characterizes Stage one sleep and how long does it last?
Low amplitude mixed-frequency brain activity and 1 to 5 minutes
206
What characterizes Stage two sleep?
Sleep spindles or spindles that are different in length
K complexes
207
Sleep spindles and K complexes are unique to what kind of sleep?
NREM with greatest frequency in Stage two
208
What happens physiologically in stage two?
HR and body temp decrease
209
How long does Stage two sleep last?
About 10 to 20 in the book and 25 on ATI
50% of a sleep cycle
210
What characterizes Stage 3 sleep?
Delta waves
211
What are delta waves?
Electrical brain waves that have a slow wave frequency and high amplitude signal
212
What happens if a person is awoken in Stage 3?
Mental cloudiness for about 30 to 0 minutes
213
What happens physiologically in Stage three?
Pulse and respirations are at their lowest rate
214
At what stage are pulse and respirations lowest?
Stage three
215
What kind of repair and health functions happen in stage three?
Immune system strengthens and muscle and tissue, and bones repair and regenerate
216
How long does stage three sleep usually last?
Up to 40 minutes
217
What happens to Stage two and three as a person ages?
They have fewer stage three cycles and more stage 2 cycles
218
What Stage takes up 5% percent of sleep?
Stage one
219
What stage is the dreaming stage?
Stage four (REM)
220
If looking at an EEG what stage looks like the awake cycle, and why?
Stage four because it has delta waves
221
What happens physiologically in Stage four sleep?
Los sod muscle tone, and Catatonia
Irregular breathing
HR is elevated
222
How long does Stage four sleep usually last?
20 minutes and up to one hour
223
What happens to the number of stage four cycles as a person ages?
They decrease
224
What sleep stage does cognitive restoration happen?
Stage four
225
How long into the sleep cycle does REM sleep start?
90 minutes
226
How long does an initial sleep cycle last?
Only 10 minutes and then gets longer the more they sleep
227
What kind of repair happens during REM cycle?
Cognitive restoration
228
What percent is the sleeping time of Stage three?
15%
229
What are the benefits of rest?
Reduced stress
Improved mode
Enhanced mental alertness and clarity
230
What sleep stage do many newborns and infants consist of when they sleep?
Stage three and four
231
At what age do half of an infants’ sleep consist of a REM cycle?
Until three months
232
At what age does an infant’s sleep begin to decrease?
5-6 mos of age
233
How do changing sleep patterns affect older adults’ health?
Adults have a harder type falling asleep so they stay in bed longer, causing musculoskeletal, arthritis, and pulmonary problems
234
How does sleep help prevent weight gain?
Decreases production of gherkin and lepton
235
What does lepton do?
Decreases hunger
236
What does ghrelin do?
Hunger hormone
237
How does sleep help reduce the risk of type two diabetes?
Lessens the release of cortisol
238
What is total sleep deprivation caused by?
Losing a night of sleep or staying awake
239
What is partial sleep deprivation?
When the person has lessened their sleep hours so the body is not meeting it’s biological sleep requirement
240
What are some affects of sleep deprivation?
Decreased higher-order cognitive processes
Impair judgment
Decrease response time
Trigger seizure disorders
Migraines and tension headaches
Accidents, depression
Stroke
Mood swings
241
What are some physiological changes in the body due to sleep deprivation?
Obesity and
Poorly controlled blood sugars
242
What are some ways to improve sleep?
Keep room dark and cold
Bedtime routine
Only go to bed when tired
Keep naps less than 30 minutes
243
How much in advance should a person avoid stimulants before bedtime to sleep well?
4-6 hours
244
How far in advance should a person work out for before going to bed?
Three hours before going to bed
245
What population has a lower quality of sleep due to sensory overload?
Acute care patients
246
How should the environment be set up in an acute health care setting to promote good sleep?
Combine tasks to avoid sleep interruption
Dim lights
Provide blindfolds and earplugs
Control pain and monitor medication effects
Lower alarm volume
247
Graveyard shift workers have higher incidence of what? (4)
Higher incidence of job dissatisfaction
Adverse health issues
CVD
Obesity
Diabetes
248
In older women, what can cause sleep disturbances?
Menopause
249
What chronic diseases are associated with insomnia?
HD
HTN
Endocrine dysfunction
arthritis
250
Sleep apnea is a reduction of what?
Nerve conduction from the brainstem to the upper airway and/or lower thoracic muscles such as the diaphragm
251
How long for no air in apnea patients?
Up to 10 sec
252
What is a worsened cause of apnea and what are it’s symptoms?
Hypopnea
10 secs or more
Decrease in O2 sat
253
What are some common causes of CSA?
Opioid OD
HF
254
What is associated with a reduction of the brain’s transmission of signals to the respiratory muscles?
CSA
255
What is characterized by episodes of upper airway collapse and obstruction while sleeping?
OSA
256
What kind of apnea is most likely characterized by snoring?
OSA
257
What is the progression of sleep?
Wakefulness
NREM- SI, SII, SIII, SIV
NREM- SIII, SII
REM
NREM- Stage II
258
What are illnesses associated with general sleep disturbances? (6)
Gastroesophageal reflux
CAD
Epilepsy
Liver failure and encephalitis
Hyperthyroidism
End-stage renal disease
259
What is the test used to document HR, BP, RR, oxyhemoglobin sate, brain wave patterns, body movements, and snoring patterns?
Polysomnography
260
What are some causes of OSA?
Inactive tongue,
Englarged tonsisls
Obesity
261
What is the most widely recommended treatment for OSA?
CPAP
262
How many people in the US complain of insomnia?
30- 35%
263
PEople with a history of what are more likely to experience insomnia?
Depression
264
What are some experience of a narcoleptic?
Nocturnal hallucinations
Paralysis while asleep
Vivid dreams
Cataplexia
265
What are the two types of narcolepsy?
NT1 with cataplexy and
NT2 without cataplexy
266
What type of narcolepsy lacks hypocretin?
NT1
267
What role does hypocretin play in sleep and wakefulness?
It is created in the hypothalamus and used for maintaining alertness
268
What are treatment options for narcolepsy?
Meds
Psychological counseling
Short naps
Support groups
269
What is it called if you have excessive daytime fatigue without improvement after more sleep?
Hypersomnia
270
What are some complications of hypersomnia?
Short attention span
Irritability
Depression
Poor memory
271
What are some causes of hypersomnia?
Dysfunctional ANS
Trauma to CNS
Genetic factors
Usually no known underlying cause
272
What is another name for Restless legs syndrome
Willis-ekbom disease
273
What is it called when a patient experiences an uncontrollable urge to move the legs, feelings of creeping, crawling, or tingling sensations?
RLS
274
When can RLS get worse?
In the evening and at bedtime
