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57 Cards in this Set

  • Front
  • Back
What are two ways to assess sleep problems?
Sleep Patterns (General Assessment forms)

Pittsburgh Sleep Quality Index (PSQI)
What is included in the PSQI?
subjective sleep quality

sleep latency

sleep duration

habitual sleep efficiency

Sleep disturbances

Sleep medication

daytime disfunction over last month
What type of score indicates a problem on the PSQI?
a 5 or above
What is sleep hygiene?
establishing a plan for sleeping.

-schedule
-timing
-exercising
-avoid meals
-remove clock

All the things you would do to make sleeping good.
How long should it take someone to fall asleep?

If longer, they have disturbed sleep pattern.
30 minutes
How many times do they have to be awoken for it to be interrupted sleep?
3+ awakenings
What drugs can you give to help with sleep?
benzodiazepines (short time though, under 2 weeks)

Do not give antihistamines (Bendaryl)
What are the first signs in the older adult's ability to perform or tolerate activity?
decrease in rate or speed of activity
What do you need with Impaired Physical Mobility?
a level

0-independent
1-uses device
2-uses assist
3-device and assist
4-dependent
What nursing diagnosis is used for the Get up and Go test?
Impaired Physical Mobility
When you think about Activity Intolerance, what are you talking about?
Patient is physically unable to do activity
What are some signs or symptoms (AEB) that patient is activity intolerant?
Change in V/S

weakness

dyspnea****Most Important
What is considered an abnormal HR in response to activity?

(when you assess s/s of activity intolerance q shift)
Abnormal HR response to activity P>100 or <50 without returning to preactivity level within 10 minutes following activity
What do you want BP to be when you assess s/s of activity intolerance q shift
A definite sign of activity intolerance would be increased systolic BP oaver 180 or diastolic over 110...or a decrease in systolic BP with activity
What is the most important piece of information to have as a defining characteristic in regard to activity intolerance?
Exertional dyspnea
Which class of medications can make an older adult feel drowsy or dizzy?
CNS depressants
When you think of pain, what ND should you be thinking of in regard to activity/exercise?
Impaired Physical Mobility

When you think of Activity Intolerance, think of v/s dyspnea, etc.
Vagus nerve stimulation would cause HR to...?
go down. With syncope and decreased LOC
Who do you not give bulk forming laxative to?
fecal impaction
Decreased tissue elasticity in lungs leads to:

1.

2.
1. impaired gas exchange

2. increased pooling of secretions in lower lobes
Decreased brain cells leads to...
decreased reflexes
Decreased nerve fibers leads to...
decreased coordination
Decreased neuroreceptors leads to...
decreased perception of stimuli

decreased motor reflexes
What is very important part of assessing for activity intolerance?
Vital Signs

HR of 20 bpm higher than resting rate and not returning to preactivity level in 10-20 minutes following activity BAD

Decreased systolic and Increased Diastolic pressure with activity BAD
Serotonin
regulates sleep in CNS
Norepinephrine
regulates wakefullness
Incotinence is ______ a normal part of aging.
NOT
Normal creatinine in adult is...
0.1-2
More than 3 days without a BM, you should...
check for impaction
notify MD
Contact MD b/4 checking for fecal impaction

(hypoactive BS)

Rectal exam is last
Prostigmine
for UI - stimulates complete emptying
Ditropan
for UI - reduces bladder spasms
Sulfonamides
treat bladder irritation 2nd to UTI
Estrogen
may be given for UI - stress
Imipramine
for BPH, causes muscles to relax and bladder neck muscles to contract

Im i Primate with a stff neck
Name two drugs that shrink the prostate.
Proscar

Avodart

(Cars and Darts shrink the prostate)
With Ditropan and Imipromine, what do you need to be careful of?
they are anticholinergics...might dehydrate

constipation
dry mm
blurred vision
ORTHOSTATIC hypotension
UI - need they can't control.
Urge Incontinence

gotta go gotta go gotta go right now
UI - decreased muscle tone but increased abdominal pressure
Stress
Distention of bladder. Loss of tone or capacity of bladder
Overflow
Artery problem with cholesterol plugging
Arteriorsclerosis
Atherosclerosis
Hardening of valves and vessels (Mitral)
What stage of sleep do you dream?
Stage 5 - REM - mental restoration
What is hallmark Digoxin toxicity sign?
halo - yellow vision
What is normal digoxin level?
0.5-2.0

Low levels of potassium predispose to digtoxicity

High Digoxin will probably have Low Potassium****test question
Hypnotics
hangover
Stage 5 sleep, what happens to gastric secretions?
they increase
Stage 5 sleep, what happens to vital signs?
they fluctuate
Most difficult to arouse someone in what stage of sleep?
5
What is the deepest stage of sleep?
4
What is stage 4 sleep responsible for?
physical restoration
What happens to V/S during stage 4 sleep?
they are lower than awake
A client should ________ periods of ________ with periods of ________ throughout the day.
A client should ALTERNATE periods of ACTIVITY with periods of REST throughout the day.
Most important intervention for activity intolerance?
assess v/s
What is the strongest piece of data that would lead to a nursing diagnosis of activity intolerance?
"I get short of breath after going up stairs"

exertional dyspnea
Patient is on coumadin. What is test?
PT
Older people have ________ brain cells. This leads to ________ _________.
fewer

slower reflexes
My old calcified lungs cause me to have...
decreased lung capacity due to rigidity of rib cage