Fundamental Nursing Skills and Concepts - PowerPoint PPT Presentation

Loading...

PPT – Fundamental Nursing Skills and Concepts PowerPoint presentation | free to view - id: dbde3-ZDc1Z



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Fundamental Nursing Skills and Concepts

Description:

A safe, clean, attractive environment, aids in reducing stress and increases comfort. ... DIURETICS INCREASE URINATION, WAKING THE SLEEPER TO EMPTY THE BLADDER. ... – PowerPoint PPT presentation

Number of Views:85
Avg rating:3.0/5.0
Slides: 27
Provided by: jim9157
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Fundamental Nursing Skills and Concepts


1
Fundamental Nursing Skills and Concepts
  • Chapter 17
  • Page 336

2
COMFORT, REST, AND SLEEP
  • COMFORT A STATE OF RELIEF FROM DISTRESS
  • REST WAKING STATE CHARACTERIZED BY REDUCED
    ACTIVITY AND MENTAL STIMULATION
  • SLEEP STATE OF AROUSABLE UNCONSCIOUSNESS
  • A safe, clean, attractive environment, aids in
    reducing stress and increases comfort.

3
MODIFYING THE ENVIROMENT TO PROMOTE COMFORT,
REST, AND SLEEP
  • Relaxing colors (light green or blue) and mauves
    pg. 337, promotes relaxation.
  • Pictures of peaceful scenes, carpeted hallways,
    adequate sunlight and artificial light, night
    lights for safety, comfortable room temperature
    and humidity, all promote a restful atmosphere.
    Temperature- optimally for pts. room 68-74, and
    humidity 30-60 .
  • Ventilation which removes odors but doesnt
    spread infection. Poor ventilation harbors odors,
    so remove the source as soon as possible. Air
    fresheners and deodorizers help but may be
    offensive to patients.

4
MODIFYING THE ENVIROMENT TO PROMOTE COMFORT,
REST, AND SLEEP
  • REMEMBER Ill clients may need cooler or warmer
    room temperatures for comfort and may not
    tolerate odors. Nurses must use good hygiene
    practices and not use too much perfume or after
    shave or smell of smoke, onions or garlic when
    giving care. May make patient nauseated.
  • REMEMBER gum chewing spreads microorganisms.

5
ROOM FURNISHINGS
  • BED (ADJUSTABLE HEIGHT AND POSITION OF HEAD AND
    FOOT, SIDERAILS, REMOVABLE HEADBOARD FOR QUICK
    ACCESS, WATERPROOF MATTRESS FOR EASY CLEANING,
    MATTRESS OVERLAYS FOR COMFORT AND INTACT SKIN).
    Bed rails can be considered a form of restraint
    so be familiar with what your institution
    observes.
  • PILLOWS AND BED LINEN. Pillows are used to
    support, position elevate and supply comfort. Bed
    linen may or may not be changed daily, depending
    on your institution. Generally linen includes
    mattress pad, bottom sheet, draw sheet (lifter),
    top sheet, spread, pillow case, blanket, may be
    used.

6
ROOM FURNISHINGS
  • PRIVACY CURTAIN- used out of respect for clients
    privacy and modesty. Remember that you can still
    hear what goes on, so keep in mind
    confidentiality.
  • OVERBED TABLE- used for holding, serving tray,
    and other equipment. Adjustable in height. Hidden
    compartments hold personal items. Mirror is
    usually included within the lid of the
    compartment.

7
ROOM FURNISHINGS
  • BEDSIDE STAND, has drawer for personal items and
    a place to store basin for bath and hygiene
    supplies. Water pitcher and glass is usually
    found on top.
  • CHAIRS, usually at least one chair is found in
    the patients room. Maybe straight hard back chair
    or a lounge type that makes into a bed. Hopefully
    they recline for the comfort of those that stay
    with their loved ones.

8
FUNCTIONS OF SLEEP
  • Promotes emotional well being, enhances various
    physiologic processes.

9
FUNCTIONS OF SLEEP cont.
  • REDUCING FATIGUE.
  • STABILIZING MOOD.
  • IMPROVING BLOOD FLOW TO THE BRAIN.
  • INCREASING PROTEIN SYNTHESIS.
  • MAINTAINING THE IMMUNE SYSTEM.
  • PROMOTING CELLULAR GROWTH AND REPAIR.
  • IMPROVING LEARNING AND MEMORY STORAGE.

10
THE TWO PHASES OF SLEEP
  • 1 NONRAPID EYE MOVEMENT SLEEP (NREM SLEEP),
    where eye movement is subdued. quiet sleep
  • Progresses through four stages
  • Slow waves on an EEG (slow wave or quiet
    sleep)

11
THE TWO PHASES OF SLEEP
  • 2 RAPID EYE MOVEMENT SLEEP (REM SLEEP) active
    sleep. Where eye movement is similar to awake
    state. Very energetic deepest stage of sleep.
    The deepest stage of sleep.
  • EEG waves similar to wakefulness (paradoxical or
    active sleep).
  • Sleep cycles- normally pass back and forth
    through four distinct phases of NREM REM, 4-6
    times during the night. Top pg. 341, see the
    length of time involved and the features of each
    cycle.

12
SLEEP REQUIREMENTS
  • Need for sleep decreases from birth to adulthood.
  • With age, less NREM sleep and more REM sleep.
  • Younger adults sleep more on weekends while older
    adults sleep more on weeknights.
  • Older adults take more naps during the day,
    nights maybe shorter due to hours slept during
    the day. They may be awake and alert at 4 a.m.
  • Urination is a problem that awakens the elderly
    at night disturbing their rest.
  • Sleep requirements vary.

13
FACTORS AFFECTING SLEEP
  • CIRCADIAN RHYTHM OF DAYLIGHT AND NIGHT. Daylight
    and darkness influence the sleep wake cycle.
  • MELATONIN SECRETION INDUCES SLEEP LIGHT
    SUPPRESSES MELATONIN SECRETION. In the absence of
    bright light, the pineal gland secrets
    melatonin, (hormone that induces drowsiness and
    sleep). Light triggers the suppression of
    melatonin secretion.
  • EXERCISE PROMOTES SLEEP, increases fatigue and
    the need for sleep, but be careful, too close to
    bedtime exercise may stimulate and not allow for
    rest.

14
FACTORS AFFECTING SLEEP
  • PEOPLE SLEEP BEST IN A FAMILIAR ENVIRONMENT, same
    noises, same habits. Usual environment induce
    sleep. Traffic noise or household noises in a new
    place may disturb rest.
  • SLEEP RITUALS HELP INDUCE SLEEP.
  • Motivation- the desire to stay awake may win out
    over the need to sleep if the motivation is
    strong enough.
  • Emotions and moods- anticipation that difficulty
    will be experienced, trying to sleep increases
    anxiety, this anxiety floods the brain with
    stimulating chemicals that interfere with
    relaxation, so natural sleep is compromised.

15
FACTORS AFFECTING SLEEP
  • Hunger or thirst interferes with sleep. Protein
    foods such as L-TRYPTOPHAN (FOUND IN DAIRY
    PRODUCTS AND POULTRY) PROMOTES SLEEP. Be careful
    of stimulants such as coffee, tea, chocolate or
    colas they contain caffeine which is a stimulant.
    Hypnotics are sleep inducing.
  • ALCOHOL INTERFERES WITH NORMAL SLEEP STAGES.
  • Illness, stress, anxiety, discomfort may alter
    your sleep pattern.

16
MORE FACTORS AFFECTING SLEEP
  • LYING FLAT WORSENS CARDIAC AND RESPIRATORY
    ILLNESSES
  • PAIN DISTURBS SLEEP.
  • EMOTIONS INTEREFERE WITH SLEEP (FOR EXAMPLE,
    ANGER OR ANXIETY).
  • DEPRESSION MAY CAUSE INABILITY TO SLEEP OR
    INCREASED SLEEP.
  • STRESS INTERFERES WITH NORMAL SLEEP PATTERNS.

17
DRUGS THAT AFFECT SLEEP
  • ALCOHOL AND CAFFEINE INTERFERE WITH SLEEP.
  • STIMULANTS CAUSE WAKEFULNESS, excite the brain.
  • DIURETICS INCREASE URINATION, WAKING THE SLEEPER
    TO EMPTY THE BLADDER.
  • SEDATIVES AND TRANQUILIZERS PROMOTE REST, produce
    a relaxing and calming effect.
  • HYPNOTICS INDUCE SLEEP.
  • SEDATIVES AND HYPNOTICS MAY HAVE A PARADOXICAL
    EFFECT ON THE ELDERLY, PRODUCING RESTLESSNESS
    INSTEAD OF SLEEP.

18
DRUGS
  • DRUG TOLERANCE, DEMINISHED EFFECT FROM THE DRUG
    AT ITS USUAL DOSAGE RANGE.
  • DIURETICS, GIVEN IN MORNING.

19
ASSESSING SLEEP PATTERNS
  • QUESTIONNAIRE COMPLETED INDEPENDENTLY BY THE
    CLIENT OR BY THE NURSE DURING AN INTERVIEW,
    IDENTIFIES SLEEP PATTERNS AND PROBLEMS (344A LIST
    QUESTIONS TO ASK PATIENT).
  • SLEEP DIARY DAILY ACCOUNT OF SLEEPING AND
    WAKING ACTIVITIES, INCLUDING FOODS CONSUMED. DONE
    EVERY 15 MINUTES FOR A 24 HOUR LOG FOR 2 WEEK
    PERIOD. MEDS ARE NOTED AS WELL FOR ANALYSIS.

20
ASSESSING SLEEP PATTERNS
  • NOCTURNAL POLYSOMNOGRAPHY DIAGNOSTIC MONITORING
    DURING AN ENTIRE NIGHTS SLEEP TO OBTAIN
    PHYSIOLOGIC DATA. (FOR EXAMPLE, BRAIN WAVES, EYE
    MOVEMENTS, AND MUSCLE TONE, LIMB MOVEMENT, BODY
    POSITION, NASAL AND ORAL AIR FLOW, RESPIRATORY
    EFFORT, SNORINGSOUNDS, OXYGEN IN BLOOD). CLIENTS
    HOME IS USED.
  • MULTIPLE SLEEP LATENCY TEST DIAGNOSTIC
    MONITORING DURING SEVERAL DAYTIME NAPS TO ASSESS
    DAYTIME SLEEPINESS. EVERY 2 HOURS, TAKE A NAP OF
    20 MINUTES, EXPERINCING EARLY REM, IS A
    PATHOLOGIC FINDING SICE REM SHOULD NOT OCCUR
    DURING A 20 MIN. TEST NAP.

21
SLEEP DISORDERS
  • INSOMNIA difficulty falling asleep, awakening
    frequently during the night, or awakening early.
    The client does not feel rested the next day.
  • HYPERSOMNIA feeling sleepy despite getting
    normal sleep. Includes narcolepsy (sudden onset
    daytime sleep) and sleep apnea/hypopnea syndrome
    (slowed or absent breathing during sleep which
    disturbs sleep and can cause heart attack or
    stroke).FIVE OR MORE TIMES AN HOUR -10 SECONDS OR
    MORE.

22
SLEEP DISORDERS
  • SLEEP-WAKE CYCLE DISTURBANCE interference with
    normal biological rhythms of sleep caused by
    shift work, jet travel, or seasonal affective
    disorder.
  • PARASOMNIA conditions associated with
    activities that cause arousal such as
    sleep-talking, grinding teeth(bruxism), restless
    legs syndrome. Includes somnambulism
    sleepwalking and nocturnal enuresis bedwetting.

23
PROMOTING SLEEP
  • MAINTAINING SLEEP RITUALS
  • PROMOTING DAYTIME EXERCISE
  • ADHERING TO A REGULAR SCHEDULE FOR RETIRING AND
    AWAKENING
  • REDUCING LIGHTING
  • EATING A SNACK OF FOOD CONTAINING L-TRYPTOPHAN
  • AVOIDING ALCOHOL
  • AVOIDING CAFFEINE (COFFEE, TEA, CHOCOLATE, COLAS)

24
TWO NURSING MEASURES THAT PROMOTE RELAXATION
  • PROGRESSIVE RELAXATION A THERAPEUTIC EXERCISE
    IN WHICH A PERSON ACTIVELY CONTRACTS AND THEN
    RELAXES MUSCLE GROUPS TO BREAK THE WORRY-TENSION
    CYCLE THAT INTERFERES WITH RELAXATION. Deep
    breathing, close eyes clear your mind, breathe in
    to count of 4. breathe out to the count of 6.
    Four times in succession, makes you feel very
    relaxed.
  • BACK MASSAGE RELAXES TENSE MUSCLES AND IMPROVES
    CIRCULATION. Table 17-5 pg. 350 massage
    techniques. Pg. 361 skill 17-3 back massage.

25
In pain
  • Assist pt. first with distraction, relaxation
    techniques, back rub, change positions, empty
    bladder. Then on to meds as needed if the
    distraction did not work.
  • After surgery, the first 24 hours, you must
    medicate.
  • Pursed lip demonstration.
  • Nursing guidelines 17-1 for progressive
    relaxation pg. 349.

26
SLEEP AND OLDER ADULTS
  • OLDER ADULTS HAVE MORE DIFFICULTY FALLING ASLEEP,
    AWAKEN MORE READILY, AND SPEND LESS TIME IN THE
    DEEPER STAGES OF SLEEP.
  • COGNITIVE IMPAIRMENT MAY PRODUCE SUNDOWN SYNDROME
    (ONSET OF DISORIENTATION AS THE SUN SETS) OR
    SUNRISE SYNDROME (EARLY MORNING CONFUSION).
  • HYPNOTIC AGENTS TEND TO HAVE PARADOXICAL EFFECTS
    AND INTERFERE WITH REM SLEEP.
  • HYPNOTICS WITH A SHORT HALF-LIFE ARE BETTER
    TOLERATED.
About PowerShow.com