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36 Cards in this Set
- Front
- Back
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What part of the CNS controls wakefulness?
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RAS (reticular activating system)
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What part of the CNS controls sleep?
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pons/medulla (brain stem)
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disorders of initiating and maintaining sleep
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intrinsic sleep disorders
ex. insomnia, narcolepsy, restless leg syndrome, sleep apnea |
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sleep disorders that develop from external factors, which if removed, lead to resolution of the sleep disorder
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extrinsic sleep disorders
ex. inadequate sleep hygiene, insufficient sleep syndrome, etc. |
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sleep disorders that arise from a misalignment between the timing of sleep and what is desired by the individual or is a societal norm
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circadian rhythm sleep disorders
ex. time-zone change syndrome (jet lag), shift-work sleep disorder, delayed sleep phase syndrome |
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undesirable behaviors that occur predominantly during sleep
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parasomnias
ex. sleep walking, sleep talking, nightmares, sleep paralysis, SIDS, teeth grinding, bed-wetting |
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Name some medical/psychiatric disorders that can cause problems with sleep.
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mood disorders
anxiety disorders psychoses alcoholism dementia Parkinsonism central degenerative disorders COPD peptic ulcer disease |
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Name some proposed sleep disorders.
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menstruation-associated
pregnancy-associated sleep choking syndrome |
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involves the use of EEG, EMG, and EOG to monitor stages of sleep and wakefulness during nighttime sleep
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polysomnogram (PSG)
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provides objective information about sleepiness and selected aspects of sleep structure by measuring eye movements, muscle-tone changes, and brain electrical activity during at least 4 napping opportunities spread throughout the day
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multiple sleep latency test (MSLT)
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worn on the wrist and measures the sleep-wake patterns of clients over an extended period of time
provides data on sleep time, sleep efficiency, number and duration of awakenings, and levels of activity and rest |
actigraph
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What pharm class of drugs is known to cause nightmares, insomnia, and awakening from sleep?
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beta blockers
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Name some factors that prevent restful sleep.
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unusual sleep patterns
emotional stress environment (ventilation, mattress, noise, light) illness/pain exercise/fatigue food and caloric intake patterns poor sleep hygiene or habits |
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What are some symptoms of acute insomnia (sleep deprivation)?
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ptosis
blurred vision fine motor clumsiness decreased reflexes decreased reasoning and judgment decreased auditory/visual alertness confusion and disorientation irritability agitation hyperactivity decreased motivation |
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How long does acute insomnia last?
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1 night to 2 weeks
*often caused by emotional or physical discomfort |
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sleep difficulty at least 3 nights per week for one month or more
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chronic insomnia
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sleep disorder characterized by repeated collapse of the upper airway during sleep, with consequent cessation of breathing lasting 10 seconds or more
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sleep apnea
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What is used as a last resort to treat sleep apnea?
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tracheostomy
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_________ by itself is not a satisfactory treatment option for sleep apnea because sleep patterns remain disrupted.
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oxygen
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sleep disorder that is caused by the brain's inability to regulate sleep-wake cycles
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narcolepsy
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What are the main symptoms of narcolepsy?
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excessive daytime sleepiness
abnormal REM sleep |
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What types of drugs are used to treat narcolepsy?
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Modafinil (wakefulness-promoting agent)
tricyclic antidepressants SSRIs |
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theory that suggests that pain impulses pass through when a gate is open and that impulses are blocked when a gate is closed
Closing the gate is the basis for pain-relief interventions. |
gate-control theory of pain
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type of pain that is protective, has an identifiable cause, is of short duration (less than 6 months), and has limited tissue damage and emotional response
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acute pain
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type of pain that is NOT considered protective and thus serves no purpose; it lasts longer than anticipated, may NOT have an identifiable cause, and leads to great personal suffering
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chronic pain
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type of pain that involves normal processing of stimuli that damage normal tissues or has the potential to do so if prolonged; usually responsive to nonopioids and/or opioids
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nociceptive pain
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What are the 2 types of nociceptive pain?
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somatic (bone, joint, muscle, skin, connective tissue)
visceral (organs, such as GI tract or pancreas) |
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type of pain that involves abnormal processing of sensory input by the PNS or CNS; treatment usually includes adjuvant analgesics
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neuropathic pain
*may be centrally generated or peripherally generated |
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pain resulting from stimulation of skin
is of short duration and is localized; usually a sharp sensation ex. needle stick, small cut, laceration |
superficial/cutaneous
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pain resulting from stimulation of internal organs
diffuse and may radiate in several directions; may be sharp, dull, or unique to organ involved |
deep/visceral
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pain felt in part of body separate from source of pain
ex. MI, kidney stones |
referred pain
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sensation of pain extending from initial site of injury to another body part
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radiating
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Name some non-verbal and behavioral indicators of pain/discomfort.
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moaning
crying gasping grunting grimace clenched teeth lip biting restlessness muscle tension pacing avoidance of conversation reduced attention span |
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What are some physiological responses to pain?
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increased respiratory rate
increased heart rate increased blood glucose level increased muscle tension increased blood pressure sweating pupil dilation decreased gastric motility |
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form of cutaneous stimulation that involves stimulation of the skin with a mild electrical current passed through external electrodes
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transcutaneous electrical nerve stimulation (TENS)
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What clients should not take Fentanyl?
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those who are opioid naive
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