When people are at rest they usually feel mentally relaxed free from anxiety and physically calm. Rest does NOT imply inactivity.
Sleep
sleep is a recurrent altered state of consciousness that occurs for sustained periods. sleep is a cyclical physiological process
What is the purpose of sleep?
conservation of energy
Hypothalamus
control center for sleeping and walking
Reticular Activating System (RAS)
facilitates reflex and voluntary movements. Controls cortical activities related to state of alertness
Sleep Cycle
the person passes consecutively through four stages, the pattern is then reversed.
Stages of sleep
Stage I and II- 5%-50% of sleep, light sleep.
Stage III and IV- 10% of sleep, deep sleep states (delta sleep)
Stage I
lightest level of sleep , lasts a few minutes, easily aroused by sensory stimuli, waken a person feels as though daydreaming has occurred.
Stage II
period of sound sleep relaxation progresses arousal is still relatively easy. stage lasts 10-20 minutes body functions vital signs and metabolism slow.
Stage III
involves initial stages of deep sleep sleeper is difficult to arouse and rarely moves. Muscles are completely relaxed and lasts 15-30 minutes.
Stage IV
very difficult to arouse sleeper, deepest stage of sleep. if sleep loss has occurred sleeper will spend great time
The lightest level of sleep occurs in
NREM I
The type of peripheral nerve fibers that transmit rapid painful stimuli are called:
A-delta myelinated fibers
Sharp, aching, throbbing, well localized pain are charateristics of which of the following classifications of pain by quality:
Somatic
The fastest growing subset of the population is
85 and >
The category of disorders that refers to the general impairment of intellectual functioning that interferes with social and occupational functioning is known as:
dementia
A person in their mid-50's may be experiencing this Developmental Task (Erikson's):
ego integrity vs. despair
A family that includes relatives such as aunts, uncles, grandparents, etc. is called a:
extended family
An example of an ego-defense mechanism includes:
conversion
If your patient is experiencing a crisis, safety concerns such as potential for suicide or homicide should be assessed.
true
Sexuality is related to all dimensions of health.
true
REM sleep
vivid full color dreaming may occur in REM sleeping.
begins about 90 minutes after sleep begins.
rapidly moving eyes, fluctuating heart and resp. rate. and BP increased.
REM sleep 2
loss of skeletal muscle tone
gastric secretions increase
very difficult to arouse
duration averages at 20 mins.
Dysomnias
Insomnia, Hypersomnia, Narcolepsy, sleep apnea, restless leg syndrome, sleep deprivation
Insomnia
Chronic difficulty falling asleep, frequent awakenings from sleep, short sleep or nonrestorative sleep.
sleep apnea
disorder in which individual cannot sleep and breath at the same time, lack of airflow through the nose and mouth for periods from 10 seconds to 1-2 minutes, there are three types: Central, obstructive and mixed
Central sleep apnea
caused by cessation of diaphragmatic and intercostal respiratory control center, impulse to breath fails temporarily least common form
Obstructive apnea
most common form, characterized by cessation of airflow despite the effort of breath, occurs when muscles or structures of the oral cavity or throat relax during sleep, usually have loud snoring.
Narcolepsy
a CNS dysfunction of mechanisms that regulate sleep and wake states, falls asleep uncontrollably at inappropriate times, treated with stimulants.
Sleep Deprivation
blurred vision,fine motor clumsiness, decreased reflexes, slowed response time, decreased reasoning and judgment, cardiac arrhythmias, confusion, disorientation, increased sensitivity to pain, irritable, withdrawn, agitation, decreased motivation
sleep problems that are more common in children, one common exception in bruxism (tooth grinding) SIDS, somnambulism (sleep walking), nightmares, nocturnal enuresis (bedwetting)
Pain
whatever the experiencing person says it is, existing whenever he or she says it does
Origin of pain
physical cause- can be identified
Psychogenic- cannot be identified
referred- pain is perceived in an area distant from its point of origin
DEEP, diffuse, originates in tendons, ligaments, bones, and nerves. EX:muscle sprain
Visceral Pain
poorly localized, originates in thorax, cranium, and abdomen, occurs when organs become distended, ischemic, inflamed
Neuropathic Pain
centrally generated:results from an injury to the peripheral nerves or CNS. peripherally generated: described as burning or stabbing, polyneuropathies, mononeuropathies
Transduction
stimuli releases pain producing substances
Transmission
painful stimuli produce nerve impulses that travel to the spinal cord, myelinated A delta fibers (fast, sharp localized and distinct sensations) unmyelinated C fibers (slow, impulse that are poorly localized, visceral and persistent.
Modulation
neurons descend spinal pathway(inhibit nocieptive and interneurons in the ascending pathway) endogenous opioids and neurotransmitters and inhibit transmission (serotonin and norepinephrine) productive pain reflex (interpretation allows person to withdraw from pain causing source) neurotransmitters-substances affecting the transmission of nerve stimuli (excite, substance P, inhibit, endorphins)
Perception
CNS extracts location, duration and quality of pain impulse, thalamus- sends to many areas of brain, person becomes aware any factors interrupting or influencing normal pain perception affects the persons awareness and response to pain(normal fatigue, depression, or pain control therapies
