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55 Cards in this Set
- Front
- Back
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4 stages of NREM |
stage 1 & 2: drift off, feel self relax stage 3: 50% of sleep spent here stage 4: deep restful sleep; 10-15% -as you age you spend less time in stage 4 |
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REM |
-reach psychiatric equilibrium -20-25% of sleep time spent here -increase heart and respiratory rate -progress into this stage after stage 4 of NREM |
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what happens if you don't reach the equilibrium of REM? |
-mental state out of whack -mood swings -change in appetite -drowsiness |
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insomnia |
-inability to sleep -30-50% of adults experience -sign of mental/physical stress -may be initial, intermittent, or terminal |
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initial, intermittent, terminal |
initial: at time of onset (1-2 weeks) intermittent: coming/going based on life stressors (3 weeks) terminal: > 1 month |
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who experiences insominia more? |
females |
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sedative |
-relaxes, quiets, and rests the body -take too many = makes you sleepy -most used to decrease anxiety |
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hypnotic |
-produces sleep -allows for 8-10 hours of sleep -won't give hangover or drowsiness |
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problem with hypnotics |
improves sleeping patterns but doesn't allow you to reach REM sleep |
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uses of hypnotics/sedatives |
-improve sleeping patterns -relaxation before procedures |
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what do the effects of sedatives/hypnotics depend on? |
dosage and condition of patient |
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3 classifications of sedatives/hypnotics |
1. barbiturates 2. benzodiazepines 3. non b's |
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barbituates |
-popular in 1900s-1960s -not as popular now b/c of benzo's -controlled substance -can't use w/o prescription -"drug abuse" |
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barbiturates actions |
-relaxes CNS -decreases ability to react or make decisions -relaxes muscles -long half-life -rarely used as hypnotic -use no longer than 2 weeks |
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barbiturates uses |
-for sedatives/hypnotics -anticonvulsant -general anesthetics |
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anticonvulsant |
-phenobarbital -relaxes CNS -relieves anxiety/pain |
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barbiturates side effects |
-hangover headache -drowsiness -lethargy -muscle/joint pain -mental depression |
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what do some older adults experience with barbiturates? |
-idiosyncratic effect -euphoria, excitability, confusion, restlessness |
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benzodianepines |
-wide range from safety dose to lethal dose -lower chance for error -when OD = body tolerates well -antianxiety, anticonvulsant, muscle relaxer, hypnotic, sedative |
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benzodiazepines actions |
-similar to CNS depressent but occurs in a variety of places -when used as a sed/hyp = bind type 1/2 GABA site *initially work well for patients but become tolerant* |
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benzodiazepines uses |
-sedative/hypnotic |
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flemazenol |
used for toxicity from over dose on benzodiazepines |
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expected side effects of Benzo's? |
-hangover, lethargy, sedative effect, drowsiness -long term use = lack of concentration, inability to react -habitual use = become tolerant -monitor for liver/blood toxicity |
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non b's agents actions |
-variable effects on REM sleep -sometimes can't go through stages 3&4 of NREM -cause CNS depression from chemical classes |
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non b's agent uses |
-anithistamines like Benydrl can cause drowsiness if dosage is increased |
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non b's expected side effects? |
-hangover -lethargy -sedation |
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what can non b's cause after stopping meds? |
rebound insomnia when having dreams and nightmares |
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adverse effects of non b's |
blur vision, transient hypertension (low BP that comes and goes |
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what should you avoid when taking non B's? |
alcohol and driving |
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analgesics |
-for pain -use pain scale (1 = none; 10 = worst) *pain is whatever the patient says it is* |
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acute (protective) pain |
-arises from sudden injury to body structures -increase heart rate, pulse rate, BP -lasts < 3 months |
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chronic pain |
-slower onset -last longer than 3 months |
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maligant/nonmaligant pain |
-maligant: cancer -nonmaligant: muscular neurologic disease |
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pain tolerance |
the individuals ability to endure pain |
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pain threshold |
the point at which the individual first acknowledges pain |
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pain rating scales |
-location -intesity -quality -time onset/duration/precipitating factors -measures taken to relieve pain -effect on ADL's -associated symptoms |
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pain management |
what we will provide |
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3 examples of pain management meds |
1. opiates 2. salicylates 3. nonsteroidal antinflammatory drugs |
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opiates |
act as morphine does to stimulate analgesic effect or block the effect of opiate agonist |
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opiates actions |
-agonists stimulate opiate receptors in CNS -prolonged use leads to tolerance and psychological/physical dependence |
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opiate agonist drugs |
-codeine sulfate -dilaudid -morphine/percodan -demerol -methadone -ultram/tramadol |
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opiate side effects |
-droswiness, dry mouth, nausea, vomitting, dizziness, light headedness -too many can be respiratory depression |
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opiates partial agonists |
-potency similar to morphine -tolerance will develop very quickly -with increase dosage you won't get more relief -usage = short term for moderate to severe pain |
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opiates partial agonist drugs |
-Buprenex (buprenorphine) -Stadol (butophanal) -Nubain (nalbuphine) -Talwin (pentazocine) |
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opiates partial agonists side effects |
nausea, vomitting, dizziness, dry mouth, claminess, confusion, disprientation, hallucination, respiratory depression, constipation |
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opiate antagonist |
blocks effect of opiate agonist and treats repiratory depression and counteracts excessive doses of opiates |
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opiate antagonist drugs |
-revex (nalmefene) -narcan (naloxone) *side effects are rare* |
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salicylates |
-drugs of choice for symptomatic relief of slight to moderate pain -can be used long term w/o causing drug dependence -shouldn't see sedative or hypnotic effects |
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salicylates drugs |
-Bayer, empirin, etc. (Aspirin) -Rexolate |
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NSAIDS |
-act as prostoglandin inhibitor -cox 1 or 2 inhibitor -decrease inflammation, fever, and pain -cox 2 doesn't cause GI upsetting bleeding or ulceration *aspirin like drugs* |
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NSAIDS drugs |
-motrin (cox 1) -indocin (cox 1) -toradol (cox 1) -naprosyn (cox 1) -daypro (cox 1) -tolectin (cox 1) -celebrex (cox ll) -bextra (cox ll) |
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NSAIDS side effects |
-gastric irritation, constipation, dizziness, drowsiness -long term use = confusion, hives, liver and kidney toxicity |
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other analgesics |
-combinations products -tylenol -darvon |
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nursing considerations with drugs |
-know meds taking -know history of abuse -know vital signs *we control how much goes in* |
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salicylates adverse effects |
dimming on vision ringing of ears, sweating, fever, leghargy, dizziness, thinning blood in GI tract and cause Rye Syndrome in babies |
