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____, ____, & _____ are basic human drives closely related to good physical and mental health
sleeping, eating, and sexual function
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•Difficulty initiating or maintaining
sleep
abnormality in sleep AMOUNT, QUALITY, or TIMING
dyssomnia
-
insomnia type with no external cause of the inability to sleep such as PTSD, caffeine etc.
primary insomnia
-
condition in which client exhibits abnormal behavioral or physiological events in association with sleep
parasomnia
-
what percentage of elderly experience sleep disturbance
1/2-2/3
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how are sleep cycles measured or recorded
electroencephalograph
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sleep cycle stage characterized by increasingly slow brain wave patterns and coincide with deepened sleep.
stage 1-4
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sleep cycle stage is rapid eye movement (REM) sleep characterized by vivid dreams and a comparably faster brain wave pattern that resembles awake states
stage 5
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____ is needed for body restoration and repair. rest is central to a persons perception of well being!
Sleep
-
sleep disorder characterized by difficulty in initiating or maintaining sleep and can lead to impairment in functioning
insomnia
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insomnia is considered a psychological problem if it lasts significantly long to impair functioning such as ____ month or more
1
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how is primary insomnia diagnosed
through an individuals subjective complaint. no psychological, medical, or substance related condition involved.
-
examples of substances often related to sleep problems
- alcohol
- caffeine
- diet pills
- stimulants
- amphetamines
-
medicinal short term treatment for insomnia
benzodiazipine
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nursing diagnoses for elderly client caused by loss of spouse, social pattern, retirement, etc
risk for sleep disturbance
-
what is the treatment for insomnia
sleep hygiene
-
specific activities that assist many persons to achieve restful sleep
sleep hygiene
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The only approved FDA long term medication for insomnia that may be associated with depression
Lunesta (eszoplicone)
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sleep hygiene techniques
- •Use bed for sleep and sexual activities
- only
•If sleepless, get up until drowsy
•Arise at same time every day
•Exercise each day
•Keep bedroom quiet, dark, and cool
•May help to have light snack
•avoid daytime napping
-
how can the cycle of insomnia possibly be broken
stay awake for the entire night
-
condition of alveolar hypoventilation secondary to massive obesity
breathing related sleep disorder "pickwickian syndrome"
-
daytime sleepiness is associated with:
- breathing related sleep disorders
- narcolepsy
- primary hypersomnia
-
Obstructive sleep apnea; tissue obstruct the flow of air to lungs
breathing related sleep disorder
-
–Daytime sleepiness without
explanation
–They do not suffer from a sleep
disorder
primary hypersomnia
-
the time it takes to fall asleep
sleep latency
-
–Irresistible need for brief periods
of sleep; Feel remarkably refreshed; real world/dream images
–Rare; common among close relatives
narcolepsy
-
the sensation of being unable to move, speak, or breathe
sleep paralysis
-
sudden loss of muscle power at times of sudden emotion, often laughter or fear
cataplexy
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individuals have Profoundly disturbed sleep, Nightmares, Sleep terrors, Sleepwalking episodes, and Restless leg syndrome
parasomnia
-
individual awakens in fear with
sweating/tachycardia and a good recall
nightmare
-
no recall of the sleep-related event, usually rouse suddenly from sleep with a cry or scream
sleep terror
-
not fully conscious but could be coherent
sleep walking
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condition associated with poor sleep described as an uncomfortable sensation in the leg when at rest that often requires constant movement
restless leg syndrome
-
treatment for nightmares, typically for children
reassurance
-
what do nightmares occasionally reflect
significant anxieties and unrecognized traumatic experience
-
treatment for sleepwalking
good management to ensure protection from injury
-
treatment for RLS
- antiparkinsonians
- benzodiazipines
- opiates
- anticonvulsants
-
assessment for sleeping disorders
assess clients normal sleep patterns and environmental changes
-
nursing diagnosis for sleep disorder
- •Sleep deprivation
- •Disturbed sleep pattern
-
outcome for client experiencing sleep disorder
- Client will:
- •Experiences restorative sleep
- •Describe falling asleep easily
-
planning/intervention for Pt experiencing sleep disturbance
- educate client with:
- •Standard sleep hygiene protocol
- •Use of Guided relaxation, music therapy, Massage,
•Support and reassurance for nightmares
-
evaluation for Pt. with sleep disturbance
•Outcomes will be subjective
•Sleep may not be directly observed
-
3 major aspects of bulimia
fasting, binging, purging
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the prevalence of bulimia is most common amongst
adolescents and young adults
-
characterized by a preoccupation of weight and bodily appearance and by recurrent episodes of binge eating dominated by lack of control
bulimia nervosa
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what types of behaviors are seen to be used with people trying to restrict weight gain with binge eating
vomiting, fasting, and excessive exercise
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what can recurrent vomiting due to bulimia lead to, which can also be used as a helpful diagnostic tool.
erosion of teeth enamel, tooth decay, and stone formation in salivary glands
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frequent vomiting and weight loss from bulimia can lead to _____ and result in ______
fluid and electrolyte imbalance.....heart arrythmias
-
bulimia is more common among
females
-
treatment for bulimia
- •SSRIs- antidepressants
- –Prozac
-
failure to improve bulimia is associated with what types of disorders
- borderline
- narcissistic
- antisocial
- depression
-
____ can improve short-term benefit by
reducing the frequency and severity of symptoms in cases with bulimia
cognitive-behavioral therapy
-
serious medical condition characterized by a profound disturbance in body image. persons with this condition view themselves as undesirably fat even when clinically emaciated
anorexia nervosa
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requirements for diagnosing anorexia
- Weight is 15% below IBW
- loss of menstruation due to malnutrition
- has intense fear of gaining weight
-
dry skin, downy hair called lanugo, and complaints of feeling cold are s/s of
anorexia
-
treatment for anorexia
- •Psychotherapy
- •Hospitalization
- •Behavioral therapy
- •Forced feeding when necessary
- •Cognitive therapy
- •Improved nutritional status
-
anorexic individuals can process interoceptive stimuli which means:
the sensation of being hungry and full
-
what is considered the mainstay treatment for anorexia
psychotherapy
-
when an individual is severely emaciated what is the most important thing to do?
restore nutritional balance before restoring psychological issues
-
what will the nurse need to know during the assessment?
- •Weight history
- •Eating and purging experiences
- •Degree of distress/anxiety
- •Identification of motivation for
- treatment
-
nursing Dx for anorexia
- •Imbalanced nutrition: –Less than body requirements
- •Disturbed body image
- •Chronic low self-esteem
- •Social isolation
- •Ineffective health maintenance
-
nursing outcomes for anorexia
- •Identify realistic outcomes
- •Recognize chronic nature of diseases
- •Focus on short-term outcomes
-
planning/intervention for anorexia
- •Four stages of treatment:
- –Nutritional rehabilitation: stop starvation
- –Psychotherapy: raise self esteem/assertiveness
- –Maintenance: monitor own eating pattern
- –Follow-up care:
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____ is part of human personality, is private and personal, and based on cultural and societal
views
sexuality
-
internal sense that one is male or female
gender identity
-
learned expressions of maleness or femaleness
gender role
-
any sexual act that is consensual, lacks force, is mutually satisfying, and is conducted in private
normal sexual behavior
-
occurs when a person experiences problems with any aspect of sexuality such as change in desire, excitation, and/or orgasm
sexual dysfunction
-
3 important topics for sexual Fx
- Sexual thoughts
- fantasies
- behaviors and preferences
-
prior to sexual hx assessment what should a nurse evaluate
evaluate ones own feelings about sexuality
-
why do sexuality questions usually remain unaddressed
nurses and doctors are uncomfortable with asking related sexuality questions
-
disorder of sexual thought, fantasy and behavior
paraphilia
-
disorder of sexual Fx include difficulty with:
sexual interest, arousal, and orgasm
-
2 categories of sexual disorder
- –Disorders of sexual functioning
- –Paraphilias
-
what are the typical seqential stages of human sexual response
- sexual interest or desire
- sexual excitement
- orgasm
- resolution
-
when is a Dx of dysfunction made for sexual disorders
when the observed problem causes significant discomfort to the individual or couple
-
disorders of sexual Fx
- •Disorders of desire
- •Premature ejaculation
-
elevations of what hormone may reduce libido or sex drive
prolactin
-
exposing ones genitals to a stranger; creates a response of fear and disgust
exhibitionism
-
sexual arousal occurring from contact with a nonliving object; etc. heterosexual males that dress as women
fetishism
-
individuals seeking sex change
gender dysphoria
-
sexual interests primarily directed toward children
pedophilia
-
pedophiles often exhibit other paraphilias such as ____ & _____
voyeurism & frotteurism
-
observing or fantasizing about observing others disrobing, naked, or involved in sexual activity
voyeurism
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recurrent sexual touching of a nonconsenting individual, usually a stranger and usually in a crowded place
frotteurism
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sexual excitement resulting from fantasizing about or participating in the infliction of suffering on others; may result in extreme injury or death
sexual sadism
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