Ati Predictor Basic Care & Comfort Part 2

Front 1

What type of diet should a person c Chron's disease consume?

Back 1

-low fiber, low-residue diet

Front 2

What are some ex of food items that a person c Chron's CANNOT eat?

Back 2

-raw veggies, veggies not strained, dried beans, peas, & legumes
-raw fruits, fruits c skins, seeds
-nuts, raisins, rich desserts
-whole grain breads/cereals
-fried, smoked, pickled/cured meats
-alcohol, fruit juices c pulp

Front 3

When teaching a clt c dumping syndrome about meal frequency, what should the RN include?

Back 3

-meal sizes should be reduced
-6 small feedings

Front 4

A clt c Dumping syndrome asks "can I drink water c my meals?" how should the RN respond?

Back 4

-no drinking fuilds c meals
-you can drink 30-45 mins before/after meals
--> this helps prevent distention or a feeling of fullness

Front 5

What types of foods should a person c Dumping syndrome eat?

Back 5

-dry foods c low carb content
-moderate protein & fat content
-restrict refined sugar intake
-proteins & fat are increase (meat, cheese, eggs, mild products)
-->to promote rebuilding of the body tissues & to meet energy needs (pg 1027 med-surg)

Front 6

A clt c dumping syndrome asks the RN "Can I eat my favorite jelly donut toped with sugar?". How should the nurse respond?

Back 6

-no, concentrated sweets (honey, sugar, jelly, jam) b/c these can cause dizziness, diarrhea, & a sense of fullness

Front 7

A clt c recently dx dumping syndrome asks, "Should I go for my usual run after lunch?" how should the RN resond?

Back 7

-no, short rest periods of 30 minutes is reccommended after each meal

Front 8

What should the RN teach the clt c cholecystitis in regards to dietary restrictions?

Back 8

-items low in fat
-a weight reduction diet is reccommended (4-6wks)
-take fat soluble vit supplements

Front 9

What should the RN inform the nursing student about when explaining palative care?

Back 9

-pallitive care is providing caring interventions rather than curing interventions
-palative care can be given for any age, dx, any time, & not just durring the last few months of life

Front 10

What is the goal behind pallative care?

Back 10

-preservation of dignity becomes the goal of palliative care

Front 11

What are some positive aspects of palliative care?

Back 11

-allows clt to make more informed choices
-achieve better allevation of sx
-have more opportunity to work on issues of life closure

Front 12

What type of therapeutic relationship is the RN offering to the clt & clts family?

Back 12

-the RN is establishing a caring relationship c both clt & family

Front 13

Pallative care is managing...

Back 13

-pallative care is managing the sx of disease & therapies

Front 14

A family is going to perform care for their dying loved one. What are some nrsg objectives (r/t to the family) that are pertinate to providing physical care & psychological support to the clt?

Back 14

1. family wil be able to provide appropriate physical care for the dying clt in home
2. family will be able to provide appropriate psychological support to the dying clt

Front 15

A family is going to care for their dying loved one. What are some goals the RN must develop in order for the family to take over care?

Back 15

-Describe & demonstrate feeding techniques & selection of foods to facilitate ease of chewing & swallowing
-Demonstrate bathing, mouth care, & other hygiene measures & allow family to perform return demo
-show video on simple transfer techniques to prevent injury to themselves & clt, help family practice transfers
-instruct family on need to enforce rest periods
-teach family to recognize ssx to expect as the clts condition worsens & provide info on who to call in an emergency
-discuss ways to support the dying person & listen to needs & fears
-solicit questions from family & provide info as needed

Front 16

A family is going to care for their dying loved one. What kinds of items the RN should evaluate the family in order to care for the clt?

Back 16

-Have the family demo physical care techniques
-ask family members to describe how they vary approaches to care when the clt has ssx such as pain/fatigue
-ask the family to discuss how they feel about their ability to support the clt

Front 17

What are some ssx of stage 1(forgetfulness) Alzheimer's disease?

Back 17

-short term memory loss
-decreased attention span
-subtle personality changes
-mild cognitive deficits
-difficulty c depth perception

Front 18

What are some ssx of stage 2 (Confusion) Alzheimer's disease?

Back 18

-obvious memory loss
-confusion, impaired judgement, confabulation
-wandering behavior
-sundowning (more confusion in late afternoon/early evening)
-irritability & agitation
-poor spatial orientation, impaired motor skills
-intensification of sx when the clt is stressed, fatigued, or in an unfamiliar environment
-depression r/t awareness of reduced capacities

Front 19

What are some ssx of stage 3 (Ambulatory dementia) Alzheimer's disease?

Back 19

-loss of reasoning ability
-increasing loss of expressive language
-loss of ability to perform ADLs
-more withdrawn

Front 20

What are some ssx of stage 4 (End Stage) Alzheimer's disease?

Back 20

-impaired or absent cognitive, communication, &/motor skills
-bowel & bladder incontinence
-inability to recognize family members or self in mirror

Front 21

T/F: assessing teaching needs for the clt & esspecially for the family members when the clt's congnitive ability is progressively declining (Alzheimer's)

Back 21

-True

Front 22

What are some appropriate interventions when the family is about to care for their loved one c alzheimer's?

Back 22

-review the resources available to the family as the clts health declines
--> a wide variety of home care & community resources may be available to the family in many areas of the country. These resources may allow the clt to remain at home rather than in an institution

Front 23

When providing daily care for a clt c progressing dementia, the RN should teach the care giver to perform a self assessment in regards to...

Back 23

-feelings of frustration, anger, or fear

Front 24

T/F: use consistent repetition of daily health routines as a means of establishing them in regards to a person c Alzheimers.

Back 24

-True
-memory loss impairs clt's ability to plan & complete specific sequential activities

Front 25

Is it appropriate for the RN to assist the clt in accepting dependency in regards to a clt c Alzheimers to ensure that all needs for the clt are met?

Back 25

-yes it is appropriate for the RN to help the clt with their feelings of accepting the dependency their disease brings

Front 26

What should the RN teach a family caring for a loved one c Alzheimers in regards to the clts independence?

Back 26

-Teach the family to encourage independence & to intervene only when the pt is unable to perform

Front 27

When bathing or performing basic hyiene to a clt c Alzheimers, how should the RN facilitate the experience?

Back 27

-provide desired personal articles (ie bath soap & hairbrush)
-facilitate clts bathing self as appropriate to facilitate independence
-provide appropriate help in hygiene

Front 28

When assisting a clt in dressing/grooming, what are some things the RN should keep in mind?

Back 28

-provide clt's cloths in accessible area to facilitate dressing
-be available for assistance in dressing as necessary to facilitate independence & provide appropriate help in dressing

Front 29

When assisting a clt c Alzheimers c toileting what should the RN help the clt c?

Back 29

-assist clt to toilet as specified intervals to promote regularity
-faciliate toilet hygiene after completion of elimination to prevent discomfort & skin breakdown

Front 30

If a clt is having trouble sleeping & resting, and this issue has not been resolved. What are 3 problems this clt is at risk for?

Back 30

1. Insomina
2. Abnormal movements or sensations during sleep or when awakening at night
3. excessive day time sleepiness

Front 31

What are 4 categories that are possible culprits for sleep disorders?

Back 31

1. Dyssomnias (originating in body systems)
2. Parasomnias (undesirable behaviors that occur during sleep)
3. Sleep disorders associated c Med-Psych disorders
4. Proposed sleep disorders

Front 32

Dyssomnias (origins in the body systems) sleep disorder are made up of....(3)

Back 32

1. Intrinsic (initiating & maintaining sleep)
2. Extrinsic (outside the body)
3. Circadian Rhythm sleep disorders (misalignment of timing & what is desired)

Front 33

Parasomnias (undesirable behaviors that occur during sleep) include...(4)

Back 33

1. Arousal Disorders
2. Sleep-wake transition Disorders
3. REM sleep disturbances
4. Other Parasomnias

Front 34

Sleep disorders that are associated c Med-Psych disorders include... (3)

Back 34

1. Psych disorders
2. Neurologic Disorders
3. Other med disorders

Front 35

Proposed sleep disorders include... (3)

Back 35

1. Menstruation-associated sleep disorders
2. Sleep choking syndrome
3. Pregnancy associated sleep disorders

Front 36

Intrinsic factors that cause sleep disturbances include... (4)

Back 36

1. Psychophysiological insomnia
2. Narcolepsy
3. Periodic limb movement disorders
4. Sleep apnea syndromes

Front 37

Extrinsic factors that cause sleep disturbances include...(4)

Back 37

1. inadequate sleep hygiene
2. insufficient sleep syndrome
3. hypnotic dependent sleep disorders
4. alcohol dependent sleep disorders

Front 38

Circadian Rhythm Sleep Disorders include... (3)

Back 38

1. Time zone change
2. Shift work sleep disorder
3. Delayed sleep phase syndrome

Front 39

Arousal sleep disorders include... (2)

Back 39

1. Sleep walking
2. Sleep Terrors

Front 40

Sleep-wake transition disorders include...(3)

Back 40

1. Sleep talking
2. Sleep Starts
3. Nocturnal leg cramps

Front 41

REM sleep disturbances include...(3)

Back 41

1. nightmares
2. REM sleep behavior disorder
3. sleep paralysis

Front 42

Other parasomnias sleep disorder includes...(3)

Back 42

1. Sleep bruxism (teeth grinding)
2. sleep enuresis (bed wetting)
3. SIDs

Front 43

Psych disorders associated c sleep disturbance include...(4)

Back 43

1. Mood disorders
2. Anxiety disorders
3. Psychosis
4. Alcoholism

Front 44

Neurologic disorders that cause sleep disturbances include...(3)

Back 44

1. Dementia
2. Parkinsonism
3. Central Degenerative Disorders

Front 45

Other medical disorders that cause sleep disturbances include...(3)

Back 45

1. Nocturnal Cardiac ischemia
2. COPD
3. PUD

Front 46

What questions can the RN ask a clt to assess for insomnia?

Back 46

1.How easily do you fall asleep?
2. Do you fall asleep & have difficulty staying asleep? How many times do you awaken?
3. What time do you awaken for good? What causes you to awaken early?
4. What do you do to prepare for sleep? To improve your sleep?
5. What do you think about as you try to fall asleep?
6. How often do you have trouble sleeping?

Front 47

What questions can the RN ask the clt to assess for Sleep Apnea?

Back 47

1. Do you snore loudly?
2. Has anyone ever told you that you often stop breathing for short periods during sleep?
3. Do you experience HAs after awakening?
4. Do you have difficulty staying awake during the day?
5. Does anyone else in your family snore loudly or stop breathing in their sleep?

Front 48

What questions can the RN ask the clt to assess for Narcolepsy?

Back 48

1. Are you tired durring the day?
2. Do you fall asleep at inopportune times?
3. Do you have episodes of losing muscle control or falling to the floor?
4. Have you ever had the feeling of being unable to move or talk just before falling asleep?
5. Do you have vivid lifelike dreams when going to sleep or waking up?