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57 Cards in this Set
- Front
- Back
What are two ways to assess sleep problems?
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Sleep Patterns (General Assessment forms)
Pittsburgh Sleep Quality Index (PSQI) |
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What is included in the PSQI?
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subjective sleep quality
sleep latency sleep duration habitual sleep efficiency Sleep disturbances Sleep medication daytime disfunction over last month |
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What type of score indicates a problem on the PSQI?
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a 5 or above
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What is sleep hygiene?
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establishing a plan for sleeping.
-schedule -timing -exercising -avoid meals -remove clock All the things you would do to make sleeping good. |
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How long should it take someone to fall asleep?
If longer, they have disturbed sleep pattern. |
30 minutes
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How many times do they have to be awoken for it to be interrupted sleep?
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3+ awakenings
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What drugs can you give to help with sleep?
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benzodiazepines (short time though, under 2 weeks)
Do not give antihistamines (Bendaryl) |
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What are the first signs in the older adult's ability to perform or tolerate activity?
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decrease in rate or speed of activity
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What do you need with Impaired Physical Mobility?
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a level
0-independent 1-uses device 2-uses assist 3-device and assist 4-dependent |
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What nursing diagnosis is used for the Get up and Go test?
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Impaired Physical Mobility
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When you think about Activity Intolerance, what are you talking about?
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Patient is physically unable to do activity
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What are some signs or symptoms (AEB) that patient is activity intolerant?
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Change in V/S
weakness dyspnea****Most Important |
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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
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What do you want BP to be when you assess s/s of activity intolerance q shift
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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
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What is the most important piece of information to have as a defining characteristic in regard to activity intolerance?
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Exertional dyspnea
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Which class of medications can make an older adult feel drowsy or dizzy?
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CNS depressants
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When you think of pain, what ND should you be thinking of in regard to activity/exercise?
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Impaired Physical Mobility
When you think of Activity Intolerance, think of v/s dyspnea, etc. |
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Vagus nerve stimulation would cause HR to...?
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go down. With syncope and decreased LOC
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Who do you not give bulk forming laxative to?
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fecal impaction
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Decreased tissue elasticity in lungs leads to:
1. 2. |
1. impaired gas exchange
2. increased pooling of secretions in lower lobes |
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Decreased brain cells leads to...
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decreased reflexes
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Decreased nerve fibers leads to...
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decreased coordination
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Decreased neuroreceptors leads to...
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decreased perception of stimuli
decreased motor reflexes |
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What is very important part of assessing for activity intolerance?
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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 |
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Serotonin
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regulates sleep in CNS
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Norepinephrine
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regulates wakefullness
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Incotinence is ______ a normal part of aging.
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NOT
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Normal creatinine in adult is...
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0.1-2
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More than 3 days without a BM, you should...
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check for impaction
notify MD Contact MD b/4 checking for fecal impaction (hypoactive BS) Rectal exam is last |
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Prostigmine
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for UI - stimulates complete emptying
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Ditropan
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for UI - reduces bladder spasms
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Sulfonamides
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treat bladder irritation 2nd to UTI
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Estrogen
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may be given for UI - stress
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Imipramine
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for BPH, causes muscles to relax and bladder neck muscles to contract
Im i Primate with a stff neck |
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Name two drugs that shrink the prostate.
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Proscar
Avodart (Cars and Darts shrink the prostate) |
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With Ditropan and Imipromine, what do you need to be careful of?
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they are anticholinergics...might dehydrate
constipation dry mm blurred vision ORTHOSTATIC hypotension |
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UI - need they can't control.
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Urge Incontinence
gotta go gotta go gotta go right now |
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UI - decreased muscle tone but increased abdominal pressure
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Stress
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Distention of bladder. Loss of tone or capacity of bladder
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Overflow
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Artery problem with cholesterol plugging
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Arteriorsclerosis
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Atherosclerosis
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Hardening of valves and vessels (Mitral)
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What stage of sleep do you dream?
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Stage 5 - REM - mental restoration
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What is hallmark Digoxin toxicity sign?
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halo - yellow vision
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What is normal digoxin level?
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0.5-2.0
Low levels of potassium predispose to digtoxicity High Digoxin will probably have Low Potassium****test question |
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Hypnotics
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hangover
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Stage 5 sleep, what happens to gastric secretions?
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they increase
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Stage 5 sleep, what happens to vital signs?
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they fluctuate
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Most difficult to arouse someone in what stage of sleep?
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5
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What is the deepest stage of sleep?
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4
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What is stage 4 sleep responsible for?
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physical restoration
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What happens to V/S during stage 4 sleep?
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they are lower than awake
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A client should ________ periods of ________ with periods of ________ throughout the day.
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A client should ALTERNATE periods of ACTIVITY with periods of REST throughout the day.
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Most important intervention for activity intolerance?
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assess v/s
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What is the strongest piece of data that would lead to a nursing diagnosis of activity intolerance?
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"I get short of breath after going up stairs"
exertional dyspnea |
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Patient is on coumadin. What is test?
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PT
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Older people have ________ brain cells. This leads to ________ _________.
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fewer
slower reflexes |
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My old calcified lungs cause me to have...
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decreased lung capacity due to rigidity of rib cage
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