Nursing 111 Exam 5 Powerpoint

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  1. Pain medications should be administered?
    At least 30 minutes before patient leaves or is discharged from the facility
  2. Which of the following interventions would be appropriate ti stimulate the sense of stereognosis in nursing home residents?

    A. Play soft music in the recreation room
    B. Prepare a fragrant cup of tea
    C. Tape pictures of loved ones on the walls
    D. Provide a soft textured blanket on the bed
    D. Provide a soft textured blanket on the bed

    Stereognosis is the sense that perceives the size, shape, and texture of objects, such as a soft blanket.

    Taping pictures to the wall stimulates the visual sense

    Playing music stimulates the auditory sense (sound)

    Making tea stimulates the olfactory sense (smell) and the gustatory sense (taste)
    (this multiple choice question has been scrambled)
  3. What can you do for the elderly to acclimate then?
    Put up signs or posters that give them the Day, Month, Time, and Weather
  4. Reticular Activating System (RAS)- To receive stimuli and respond appropriately, the brain must be alert and aroused. The RAS a poorly defined network that extends from the hypothalamus to the medulla, MEDIATES AROUSAL.
    What is responsible for the regulating of the arousal to sleep and wake up transition
  5. Preventing sensory alterations: Dealing with Pain medications
    Control patient discomfort whenever possible
  6. Caring for visually impaired patients:
    • Teach patient self-care behaviors to maintain vision and prevent blindness
    • Speak in a normal tone of voice
    • Explain reason for touching person before doing so
    • Keep call light within reach
    • Orient person to sounds in environment
    • Orient person to room arrangement and furnishings
    • Assist with ambulation by walking slightly ahead of person
    • Stay in person's field of vision if he or she has partial vision
    • Provide diversion using other senses
    • Indicated conversation has ended when leaving room

    A. Position self so light is on face
    B. Do not use pantomime to express messages to avoid embarrassment
    C. Increase noises in the background to stimulate the senses
    D. Speak to the person before making our presence known
    A. Positioning self so light is on your face allows the patient to see your lips and expressions
    (this multiple choice question has been scrambled)
  8. Living Will: Provides specific instructions about healthcare
    Advance directive specifying the medical care a person would want or refuse should he or she lack the capacity to consent to or refuse treatment himself or herself
  9. People who are grieving over animals, you cannot pity them because their pets meant a lot to them so it is a Big Thing to them.
  10. Complicated grieving- grief of the perpetrator or the organ transplant
    Meaning the person that caused the death of a family member, you feel grief if they die. Also for those who donate organs the person they gave the organ to feels grief if they knew the person who donated it was dead/died.
  11. A person who exaggerates the good qualities of his recently deceased father is experiencing what stage of Engel's grief?

    A. Restition
    B. Shock and Disbelief
    C. Outcome
    D. Idealization
    D. Idealization is the exaggeration of the good qualities the person or object had, followed by acceptance of the loss.

    Shock and disbelief are defined as refusal to accept the loss, followed by a stunned response

    Restitution involves the rituals surrounding the loss

    Outcomes involves dealing with the loss as a common life occurance
    (this multiple choice question has been scrambled)
  12. Elizabeth Kubler-Ross (1969) a pioneer in the study of grief and death reactions, defined 5 stages of reaction. Pioneer of understanding near death experiences, she was the founder of Home of Peace which was the first place to serve AIDS patients.
    • 1. Denial and Isolation
    • 2. Anger
    • 3. Bargaining
    • 4. Depression usually consist of 2 things (1. Sadness/Regret and 2. Clinical)
    • 5. Acceptance (Not everyone makes it to this stage)
  13. Denial: Patient denies the reality of death and may repress what is discussed
    Anger: The patient expresses rage and hostility and adopts a "why me?" attitude
    Bargaining: The patient tries to barter for more time
    Depression: The patient goes through a period of grief before death often characterized by crying and not speaking much
    Acceptance: When the stage of acceptance is reached, the patient feels tranquil. The reality of death has been accepted and the patient is prepared to die
  14. Durable Power of Attorney: Another kind of Advance Directive
    Appoints a person (agent) trusted by the person who is ill to make decisions in the event of a subsequent incapacity.
  15. Autopsy: Is an examination of the organs and tissues of a human body after death
    Is to establish the cause of death or to find out facts.

    The coroner is the single most powerful person because they have the ability to order the autopsy, close down a hospital if they find a virus or infection in a dead body,or for a dignified death.
  16. Lifestyle and Habits are a factor that affect sleeping
    NEVER exercise 2 to 3 hours before going to bed
  17. Which of the following snacks is an appropriate bedtime snack to promote sleep in a patient?

    A. Candy
    B. Cheese
    C. Toast
    D. Lunchmeat
    (this multiple choice question has been scrambled)
  18. You DO NOT want to leave someone on sleep medications! They are for temporary use.
    Teach the patient that it is a temporary fix, it's not something you need to do for forever or think of it as a permanent fix.
  19. Ambien is a Hypnotic/Sedative
    Make sure to always have someone around once you take this drug, ask questions before you take it
  20. Scale of how much Sleep a person needs:
    • Newborns: 12-18 hours
    • Infants (3-11 months): 14-15 hours
    • Toddlers (1-3 years old): 12-14 hours
    • Preschoolers (3-5 years old): 11-13 hours
    • School aged: Approximately 10-11 hours
    • Adolescents: 8.5-11 hours
    • Adults: 7-9 hours
  21. 90% of depressed people suffer from insomnia
  22. Obesity lends itself for people who do not get enough sleep
  23. Heart arrhythmias: Researchers found that lack of sleep doubles the risk for heart attacks and is consistent with lack of sleep

    example: chronic pain
  25. Acute Pain: Rapid onset
    Surgery or sore throat
    • Chronic Pain: Limited, intermittent, persistent, remission. It last longer than normal.
    • Certain cancers
    • Rheumatoid Arthritis (RA)
    • Peripheral Neuropathy
  26. Visceral Pain: Poorly localized and originates in body organs
    • Ex: Colon Surgery
    • Abdomen
    • Colon Resection
  27. Referred Pain: Is pain that originates in one part of the body and is perceived in an area distant to that part
    Most common in women

    Ex. Heart Attack
  28. Central Neuropathic Pain:
    Multiple Scheloris
    Some Strokes
    Can be of short duration or lingering is often described as burning or stabbing. Allodynia, a characteristic feature of neuropathic pain is pain that occurs after a normally weak or non painful stimuli, such as a light touch or cold drink.
  29. Intractable Pain: When pain is resistant to any kind of therapy and persist despite a variety of interventions.
  30. Phantom Pain: It is REAL. The pain that is often referred to an amputated leg where receptors and nerves are clearly absent is a real experience for patients.

    Its a brain thing, theory suggest that sensory misinterpretations from the missing limb may still remain in the brain thereby causing phantom pain.
    • Also called Phantom Limb pain
    • Approximately 82% of people who lose a limb have phantom pain
    • When you say your foot is itching and its not even there
  31. Which of the following modulators of pain it thought to reduce pain sensation by inhibiting the release of substance P from the terminals of afferent neurons?

    A. Enkephalins
    B. Dynorphins
    C. Nociceptors
    D. Endorphins
    A. Enkephalins are thought to reduce pain by inhibiting the release of substance P from the terminal of afferent neurons.

    Endorphins and Dynorphins are released when certain measure are used to relieve pain.

    Nociceptors are the peripheral nerve fibers that transmit pain.
    (this multiple choice question has been scrambled)
  32. When in pain a patients Blood pressure and pulse will INCREASE
  33. Past pain experience: If 10 people go to the hospital for a surgical procedure which is the least stressed?
    A person not fearful or has had pain before and it was solved therefore, Pain needs have been met
  34. Wong-baker FACES are a pain assessment tool and is usually used with KIDS
  35. When your doing patient teaching or when a patient has surgery what's your responsibility to tell the patient?
    Tell them that they need the medication/pain med for there post operation and it will not get them hooked. In order to heal they need it, it is for pain control.

    Patient will say: " I don't want to get hooked."
  36. Pain medications cause constipation. What are you going to do and encourage for them after surgery?
    Increase fluid and bulk
  37. Children do have the neurological development ability to feel pain. The belief that they do not have this ability is wrong.
    Ex. Circumcision

    They say it is better to do it once a child is born because they can't feel the pain and they CAN!
  38. The thought that it is better to wait until the pain gets really bad is a misconception. You should give it before it gets to this point.
  39. Always give pain medication at least a minimum of 30 minutes before a procedure.  
  40. Behavior responses to pain:
    Restless in bed
    • Involuntary increase in Blood Pressure, respiration rate
    • Pupil dilation
    • Tense muscles
  41. Diabetics sugar gets higher with the stress of pain. The responses to pain are N/V, irregular breathing, and fainting.
  42. A sedated patient is frequently drowsy and drifts off during his conversation with the nurse. What number on the sedation scale best describes this patient?

    A. 4
    B. 2
    C. 3
    D. 1
    A. 3 Denotes that the patient is frequently drowsy and hard to awake

    1 means the patient is awake and alert

    2 Denotes the patient is occasionally drowsy, but easy to arouse

    At 4, the patient is somnolent with minimal or no response to stimuli
    (this multiple choice question has been scrambled)
  43. Breakthrough Pain (BTP):
    Is a temporary flare-up of moderate to severe pain that occurs even when the patient is taking ATC medication for persistent pain. Often misdiagnosed and over looked or under treated. 
  44. Patient's have the right to report pain, control pain, and be treated with respect at all times.
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Nursing 111 Exam 5 Powerpoint
Nursing 111 Exam 5 Powerpoint Questions
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