Sleep Disorders
What is the difference beteween Primary Insomnia and Comorbid Insomnia?
Primary insomnia implies that no other cause of sleep disturbance has been identified.
Comorbid insomnia is more common and is associated with psychiatric and medical disorders, medications, and primary sleep disorders, such as obstructive sleep apnea (OSA) or restless legs syndrome (RLS). Comorbid insomnia does not suggest that these conditions cause insomnia but that insomnia and the other conditions co-occur and each may require attention and treatment
What is the most common skin problem, and where does it occur
Xerosis: extremely dry, cracked, itchy skin
Occurs primarily in the extremities, most often on the legs, but can also affect face and trunk
What is a cognitive-behavioral strategy that has been used to control pain. It is based on the theory that an individual can learn voluntary control over some body processes and alter them by changing the physiological correlates appropriate to them.
Biofeedback
Describe the pathophysiology of diabetic retinopathy
Chronically high blood sugar from diabetes is associated with damage to the tiny blood vessels in the retina, leading to DR. Blood and lipid leakage leads to macular edema and hard exudates (composed of lipids). In advanced disease, new fragile blood vessels form and hemorrhage easily. Because of the vascular and cellular changes accompanying diabetes, there is often also rapid worsening of other pathologic vision conditions
Name 5 risk factors for osteoperosis
Gender (female)
Race (White)
Age
Family history of osteoporosis
Weight (underweight)
Diet (low calcium, excessive caffeine, ethyl alcohol)
Hormonal deficiencies
Activity level (low)
Medications (steroids, anticonvulsants, thyroid preparations)
Cigarette smoking
Lewy Body dementia & Parkinson's dementia
At what age should people be vaccinated for Shingles?
50
Name 4 adverse reactions/events a nurse should consider when giving an older adult an opiod analgesic
Nausea
Pruritis
Constipation
What is a cataract?
Name a risk factor for developing a cataract
Name a symptom of having a cataract
Can you treat a cataract? if so, How?
A cataract is an opacification (cloudiness) in the eye’s normally clear crystalline lens, causing the lens to lose transparency or scatter light.
age, smoking, diabetes, UV light exposure
cloudy or blurred vision, glare, halos around lights, poor night vision, a perception that colors are faded or that objects are yellowish, and the need for brighter light when reading. Everything becomes dimmer, as if seen through glasses that need cleaning.
yes, with surgery
how much calcium should a 50 year old woman get in a day?
Name 3 foods high in calcium
What is a common side effect of calcium supplements that is already a problem for many older adults?
1200mg/ day
Dairy products, Chinese cabbage or bok choy, Tofu (calcium fortified), Soymilk (calcium fortified), Orange juice (calcium fortified), Dried figs, Cheese pizza, Green/ leafy vegetables, Beans/legumes, Tortillas, Cooked soybeans, Sardines or salmon, shrimp with edible bones, Nuts (especially almonds), Bread, cereals (fortified)
Constipation
Name 3 risk factors for OSA
Increasing age
• Increased neck circumference (not as significant in older adults)
• Male gender
• Anatomical abnormalities of the upper airway
• Upper airway resistance and/or obstruction
• Family history • Excess weight • Use of alcohol, sedatives, or tranquilizers • Smoking • HypertensionWhat is the difference between a stage 1 and stage 2 pressure injury?
Stage 1 is non blanchable erthyma of intact skin
Stage 2 is partial thickness skin loss with exposed dermis
Name 3 types of pain sensations
• Nociceptive pain is associated with injury to the skin, mucosa, muscle, or bone and is usually the result of stimulation of pain receptors. This type of pain arises from tissue inflammation, trauma, burns, infection, ischemia, arthropathies (rheumatoid arthritis, osteoarthritis, gout), nonarticular inflammatory disorders, skin and mucosal ulcerations, and internal organ and visceral pain from distention, obstruction, inflammation, compression, or ischemia of organs. Nociceptive mechanisms usually respond well to common analgesic medications and nonpharmacological interventions.
• Neuropathic pain involves a pathophysiological process of the peripheral or central nervous system and presents as altered sensation and discomfort. This type of pain may be described as stabbing, tingling, burning, or shooting.
• Mixed or unspecified pain usually has mixed or unknown causes. A compression fracture causing nerve root irritation, common in older people with osteoporosis, is an example of a mix of nociceptive and neuropathic pain.
What part of the eye does Glaucoma effect?
Is Glaucoma treatable? If so, How?
What part of the visual filed does primary open angled glaucoma effect?
The optic nerve
No, damage to the optic nerve in glaucoma is irreversible; however if caught early it can be controlled with meditcations and/ or surgery
Side vision or the peripheral field
Name the top 5 most common types of Arthritis
OA, polymyalgia rheumatica (PMR), giant cell arteritis (GCA), rheumatoid arthritis (RA), and gout
Name 4 changes in sleep due to aging
What is the difference between a stage 3 and stage 4 pressure injury?
Stage 3 is full thickness skin loss with visible adipose tissue, slough or eschar may be visible
Stage 4 is full thickness skin and tissue loss, with exposed or directly palpable fascia, muscle, tendon, ligament, cartilage, or bone in the ulcer. Slough and/or eschar may be visible.
What nonopiod analgesic is effective for nociceptive pain?
What non opiod analgesic class is effective for neuropathic pain?
1. Tylenol
2. NSAIDS
What are the 2 major types of hearing loss and what is the difference?
conductive and sensorineural
Sensorineural hearing loss results from damage to any part of the inner ear or the neural pathways to the brain.
Conductive hearing loss involves abnormalities of the external and middle ear that reduce the ability of sound to be transmitted to the middle ear.
Osteoarthritis Vs. Rheumatiod Arthritis
What are the differences in onset, signs & symptoms, and medications?
OA: insideous onset, stiffness resolving within 20 minutes of rest, affects distal interphalangeal joints, knees, hips, and vertebrae, DMARDs (Disease-modifying antirheumatic drugs)
RA: acute onset, stiffening lasting more than 20–30 minutes after rest, affects proximal joints; may be systemic, NSAIDS
Name 5 medications/ med classes that affect sleep
Name 5 parts of a pressure injury prevention program
Skin evaluation for all patients looking for pressure injury
• Daily risk evaluation
• Daily skin inspection
• Moisture management
• Optimizing nutrition and hydration
• Minimizing pressure (posture changes)
• Pressure injury nursing care education
• Establishment of a wound care team
• Interprofessional cooperation
Name 5 pain cues you might observe in someone with communication or cognitive limitations
Restlessness and/or agitation or reduction in movement
Repetitive movements
Unusually cautious movements, guarding
Sudden resistance to help from others
Decreased appetite
Decreased sleep
Person groans, moans, or cries for unknown reasons
Person increases or decreases usual vocalizations
Pleading expression
Grimacing
Pallor or flushing
Physical tension such as clenching teeth or hands
Diaphoresis (sweating)
Increased pulse, respirations, or blood pressure
name a cause of conductive hearing loss
name the 2 most common types of sensorineural hearing loss
name a cause of sensorineural hearing loss
Conductive: Otosclerosis, infection, perforated eardrum, fluid in the middle ear, tumors, or cerumen accumulations cause conductive hearing loss.
1. Presbycusis (also called age-related hearing loss or ARHL) is a form of sensorineural hearing loss that is related to aging and is the most common form of hearing loss. Presbycusis progressively worsens with age and is usually permanent.
2.Noise-induced hearing loss (NIHL) is the second most common cause of sensorineural hearing loss among older adults. Direct mechanical injury to the sensory hair cells of the cochlea causes NIHL, and continuous noise exposure contributes to damage more than intermittent exposure. NIHL is permanent but considered largely preventable.
3.Other causes of sensorineural hearing loss include hereditary or genetic factors, viral or bacterial infections, noise exposure, head trauma, and ototoxic medications
Name 3 medications/ med classes used to treat Gout
Name 2 lifestyle modifications to help prevent a Gout attack
NSAIDS, corticosteroids, colchicine
avoidance of foods that are high in purine and alcohol, taking allopurinol