Definitions from Unit 5
Terms
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- Freedom form psychological and physical injury.
- Client Safety
- ANY one of numerous mechanical devices or chemical agents used to hinder or restrict a patient's movement.
- Restraint
- The use of psychotropics, hypnotics, or anxiolytics to control a potentially violent patient.
- Chemical Restraints
- The coordinated efforts of the musculoskeletal and nervous systems to maintain balance, posture, and body alignment during lifting, bending, moving, and performing activities of daily living.
- Body Mechanics
- Maintains good muscle tone and prevents injury.
- Body Alignment
- Enhanced by proper posture.
- Body Balance
- The result of weight, center of gravity, and balance
- Coordinated Body Movement
- A force that occurs in a direction to oppose movement.
- Friction
- Used for the purpose of conditioning the body, improving health, and maintaining fitness.
- Exercise & Activity
- An awareness of the body and its parts.
- Proprioception
- Controlled by the cerebellum (coordinates body movement) and inner ear (maintains balance)
- Balance
- The extent of movement of a joint, measured in degrees of a circle.
- Range of Motion (ROM)
- Individually intiated joint movement.
- Active Range of Motion (AROM)
- Assistant intiated joint movement.
- Passive Range of Motion (PROM)
- The movement of a limb away from the body.
- Abduction
- Movement of a limb toward the median axis of the body.
- Adduction
- A "straightening" movement allowed by certain joints of the skeleton that increases the angle between two adjoining bones.
- Extension
- A movement allowed by certain joints of the skeleton that decreases the angle by two adjoining bones.
- Flexion
- A condition that involves degeneration of bone mass.
- Osteoporosis
- Blood clots that have temporarily lodged in the blood vessel.
- Embolisms
- Stockings designed to prevent embolisms (blood clots) in non-ambulatory (immobile) patients and are usually only necessary while the patient is in the hospital.
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Anti-Embolism Stockings
(Ex. T.E.D. hose) - Joint activity done PRIMARILY by self w/ minimal assistance.
- Active Assist Range of Motion
- Exercise against resistance of a mobile object.
- Resistive Range of Motion
- Exercise against resistance of an immobile object.
- Isometric Range of Motion
- Sleep is a cyclical physiological porcess that alternates with longer periods of wakefulness. The sleep-wake cycle influences and regulates physiological function and behavioral responses.
- Physiology of Sleep: KNOW!!
- The external pattern of diminished activity for mental and physical rejuvenation.
- Rest
- The extent and pattern of natural periodic suspension of consciousness during which the body is restored.
- Sleep
- The 24- hour diurnal (day time active) day-night cycle. Affected by light, temperature, and external factors (such as social life).
- Circadian Rhythm
- Individualized eccentricities that determine an individual's sleep-wake cycle (i.e. morning person vs. night person).
- Biological Clock
- Includes lightest level of sleep.
- Stage 1: NREM
- Period of sound sleep.
- Stage 2: NREM
- Involves initial stages of deep sleep.
- Stage 3: NREM
- Deepest stage of sleep.
- Stage 4: NREM
- Bedwetting
- Enuresis
- Stage of sleep that usually begins about 90 minutes after sleep has begun and vivid, full-color dreaming may occur. Typified by rapidly moving eyes.
- REM Sleep
- Cycle of sleep when gastric secretions increase.
- REM sleep
- Name 3 areas of physiological behaviors that increase during REM...
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1. Pulse
2. Gastric Secretions
3. Respiratory Rates - Why do we darken the room at night?
- Stimuli from sensory organs may activate the reticular system.
- 16 hours per day
- Sleep requirements for Birth to 3 months of age.
- 14 hours per day
- Sleep requirements for 3-12 months of age.
- 12 hours per day
- Sleep requirement for 1-5 years of age.
- 10 hours per day
- Sleep requirement for 6-12 yrs. of age.
- 7.5 hours per day
- Sleep requirement for 13-19 yrs. of age.
- 6 - 8.5 hours per day
- Sleep requirement for 20-40 yrs. of age.
- Amount of sleep declines (need doesn't)
- 40-60 yrs. of age
- Episodes of REM sleep shorten and they awaken several times during the night.
- 60+ yrs of age
- Sleep drug that provides only temporary (1 week)increase in the quantity of sleep, eventually causes daytime "hangover", and may worsen sleep apnea in elderly
- Hypnotics
- Drugs that causes nocturia
- Diuretics
- Drugs that suppress REM sleep
- Antidepressants & Stimulants
- Drug that speed onset of sleep, disrupts REM sleep, and awakens a person during night and causes difficulty returning to sleep
- Alcohol (ETOH)
- Drugs that suppress REM sleep and cause increased daytime drowsiness
- Narcotics
- Drug that prevents person from falling asleep and may cause a person to awaken during the night
- Caffeine
- What do Sedatives, Hypnotics, Antianxiety drugs, and Alcohol all have in common
- All are CNS depressants
- Chronic difficulty falling asleep, frequent awakening from sleep and/or shor sleep or non-restorative sleep.
- Insomnia
- Lack of airflow through the nose & mouth for periods of 10 seconds or longer during sleep.
- Sleep Apnea
- During a normal period fo wakefullness (i.e. daytime) a person develops a sudden overwhelming feeling of sleepiness and falls asleep
- Narcolepsy
- A natural result of dyssomnia. May be due to illness or disease. Common in individuals who work rotating shifts.
- Sleep Deprivation
- Drugs that, when given at low doses, calm or soothe the CNS without inducing sleep, but at high doses induces sleep
- Hypnotic (Induces Sleep)
- Drugs that have an inhibitory effect o nthe CNS to the degree that they reduce nervousness, excitability, or irritability, without causing sleep.
- Sedatives (Calming Effect)
- What are the most common side effects of Benzodiazepines (i.e. Valium)
- Drowsiness and Ataxia
- Outer layer of skin, bacteria live here
- Epidermis
- Thick layer of skin - collagen and elastic factors, sweat
- Dermis
- Glands that secrete sweat and control temperature
- Eccrine glands
- Glands found in axilla & genitalia and creat odor from bacterial decompostition of sweat.
- Apocrine glands
- Skin layer that contains blood vessels, nerves, lymph, and fat
- Subcutaneous
- What is the best time to perform a bath?
- Whenever the patient would prefer to have one.
- When is it appropriate to try to change a patient's hygiene practices?
- When the patient's current practices are inadequate for physiological needs.
- Practices based on cultural norms (i.e. hot vs. cold showers, water vs. oil)
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Cultural Variables
(a factor that affects hygiene) - Disabilities (i.e. post stroke) or limitations (i.e. broken arm) may affect ability or desire to perform certain self-care functions (i.e. brushing teeth)
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Physical Condition
(a factor that affects hygiene) - In assessing hygiene what is muscle strength, flexibility/dexterity, balance, coordination, and activity tolerance level considered...
- Self Care Ability
- In assessing hygiene what are personal preferences
- Hygienic Practices
- In assessing hygiene what is the need to consider "personl space" factors prior to procedures such as bed bath
- Cultural Factors
- A localized area of tissue necrosis (death) that tends to develop when soft tissue is compressed between a bony prominence and an external surface for a prolonged period
- Pressure Ulcer/Decubitus Ulcer (bedsore)
- Localized abscence of blood or major reduction of blood flow resulting from mechanical obstruction
- Tissue Ischemia
- Death of cells.
- Necrosis
- Pinkness will not come back after pushing on skin
- Nonblanchable (Ex: edema)
- Stage where there is nonblanchable erythema on exam, skin remains intact, and is relatively easy to repair.
- Decubitus Ulcer Stage I
- Stage of partial thickness, involves dermis and epidermis, appears as an abrasion, blister, or shallow crater on exam, and skin may appear red and puffy
- Decubitus Ulcer Stage II
- Stage where there is full thickness skin loss, includes subcutaneous tissue, may be necrotic, deep cratering and undermining, more difficult to heal due to lack of oxygenation and blood supply.
- Decubitus Ulcer Stage III
- Stage with full thickness ulcer, involves tendon, bone, ligament, and/or joint, extensive destruction and tissue necrosis, and VERY difficult to heal.
- Decubitus Ulcer Stage IV
- Normal red tones of light skinned clients are absent (doesn't normally appear on dark skinned individuals)
- Blanching
- Period of time that it takes for pink coloration to return to nail bed after pressure applied (average time <2 seconds)
- Capillary Refill
- What PHYIOLOGICAL changes take place through bathing:
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-Improved Circulation
-Improved Respirations
-Maintenance or improvement of muscle tone - When managing a Stage I-II Ulcer what would be sufficient for early erosions?
- Topical antibiotics under moist steril gauze.
- When managing a Stage I-II Ulcer what may be needed for debridement?
- Normal saline wet-to-dry dressings
- When managing a Stage I-II Ulcer what would be considered for use if ulcer has not healed 30% within 2 weeks?
- Hydrogels or hydrocolloid dressings.
- In managing Stage III-IV Ulcers what does surgical management include:
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-Debridement of necrotic tissue
-Bony prominence removal
-Flaps
-Skin grafts