fundamentals of nursing mobility – Flashcards
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what are some more important things to look at for immobile client
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check vitamin d levels
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what is first symptom of vitamin d poisoning
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sever rash/itching
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what are important blood chemistry changes with immobile client
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netative nitrogen balance, calsium reabsorption
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how can nurse check for these problems
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initial height and weight take yourself, mointor serium protein, albumum, calsium and phosphate
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what type of diet is best for immobiel client and why
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high protein high carbohydrate to reduce muscles wasting in provide enough calaries for metabolitc activity and for healing
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what is simple evidience gi is working
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presense of gas
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describe range of motion
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ROM is the maximum amount of movement aviable at a joint in one fo three planes
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what are the three planes for range of motion
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sagittal (left and right), frontal-front and back, transverse upper and lower
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what are the types of ROM
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active (patient does) passive nurse does or patient with good arm but limb doesn't move itself
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what do static excercises help with
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muscle tone
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what do resistive excercies help with
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osteoblastic activity
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Theraputic affects of bed rest
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promotes healing and repair by decrasing metabolic needs, reduces pain, reduces venous conetions in lower extremities and other dependent arease, allow debillitated patients to rease, reduces bodfies need for exegen due to decrased metabolism, reduces fluid in legs, sacrum patient flat mean scrum and develop fluit, dependent body part fights gravity, dependent areas tend to collect fluid
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name some dependent areas
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back of head, elbows
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what are negative affects of bedrest
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metobolic changes, negative nitrogen balance, amonia an protien, motabolism slows down, calcium reabsorption calcium exits bones into blood stream,
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what is sleep
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cyclical process that alternates with longer periods of wakefullness
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How does sleep influence body
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sleep wake cycle influences and regulates physiology and function and behavioral responses
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what are some comon rhythms
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circadian (24 hours), infradian greater than 24 hours (menstration), ultradian (less than 24 hours)
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What effects the bodies circadian rhythm
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light, temperature we have a biological clock can be a morning person
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what else changes during the circadian rhythm
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temperature, blood pressure, heart rate, harmone secreation,
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what does sleep effect
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peripheral vascular, nervous, endocrine, cardiovascular respsiratory muscular
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what does an eeg measure
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brain wave activity
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what does emg measure
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muscle activity
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what does eog measure
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eye activity
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what are the two major stage of sleep
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REM and NREM
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what are the phases of the average sleep cycle
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Pre sleep - NREM 1 - NREM 2 - NREM 3 -NREM 4 NREM 3 - NREM 2 - REM
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When does a person reach REM sleep
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about 90 minutes into the cycle
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Ho does the length of REM change over night
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It lengthens approaching 60 minutes
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How does age affect sleep
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sleep becomes more fragmented and more time in lighter stages
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facts about NREM1
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Lightest, easiest arrousal, few minutes, gradual fall of Vital signs,
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Facts of NREM2
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period of sound sleep, relaxation prgresses, arousal remains relatively easy, 10 to 20 minutes, body functions keep slowing
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NREM3
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Initial stages of deep sleep, sleeper difficul to arouse no movement, muscles relaxed, vital signs decline but regular, 15 to 30 min
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NREM4
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Deepest stage of sleep, very difficult to arouse, if person loses sleep makes up here, vital signs significanting lower, 15 to 30 minutes, sleepwaking occurs hear and bed wetting
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REM
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vivid full color dreaming, less vivid dreaming in other stages, about 90 minutes after falling asleep, autonomic response of rapidly moving eyes, fluctuating heart and respiratory ratges, increased or flucuation bp, loss of skeletal muscle tone occurs castric secretions incrase very diffucult to arouse sleeper average time 20 min increses through night
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Sleep disorders dyssommias
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intrinsic, extrinsic, circadian rhythm intrinsic - psycologocal insomnia, narcolepsy, periodic olimb movement disorder, sleep apnea extrinsic - inadequate sleep hygiene, insuffienct sleep syndrom, hypnotic dependent sleep disorders, alcohol dependendt sleep disorders, circadian rhythm sleep disorders, tiem zone change, shift work sleep disorder, delayed sleep phase syndrome
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parasommjnias
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arousal disorders - sleep walking, sleep terrosr, sleep wake - sleep talkining, sleep starts, ncoturnal leg cramps, rem issues - nightmares, sleep papalysis rem sleep behavior disorder
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other sleep disorders
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sleep bruxism teeth grinding, sleep enuresis bed wetting, SID
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sleep apnea
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lack of airflow through the nose and mouth for periods of 10 seconds or longer
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types of sleep apnea
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central, obsturctive and mixed
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obstructive sleep apnea
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muscles in the oral cavit or thraot relax during sleep and upper airway becomes blocked
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types of urine collection
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regular, clean (midstream) and sterile
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what major problem to look for in person with coloscomy
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contents irritate skin, need to let gas out
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documentation with coloscomy
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tolerence, applicnce, skin care, whats in bag, I/O, patient teaching documentation essential for legal problems
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tunneling catheter
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out of favor but older doctors still use twighlight procedure
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porto cap
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can stay in years very permanent, sits under skin, look for squishy part to put meds in use non coring needle
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picc
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...
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what is common to all four lines
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flush esp with heparin, sterile dressings clean wtih hibiclens with strubby thing tghat looks like a person
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sash
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saline, antibiotic, saline heparin, must saline between antibiotics,
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oxegen
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not its not air
