mna mosby ’ s long term care assistant chapter 27 comfort, rest and sleep
TRANSCRIPT
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MNAMosby’s Long Term Care Assistant Chapter 27 Comfort, Rest and Sleep
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ComfortState of well being
No physical and emotional pain
OBRA has certain room requirements to promote comfort
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Comfort
OBRA requirements:
No more then 4 to a room
Clean, comfortable
Curtain for privacy
Appropriate linens
Odor free
Temp btw 71 – 81
Appropriate lighting
Adequate ventilation
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Pain
SubjectiveA warning from
the bodyTypes:Acute
Chronic
Radiating
Phantom
Sudden, last short timeLasts longer then 6 months, constant or on and off. Felt at site of tissue damage and in nearby areasFelt in a body part that is no longer there
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Factors effecting pain
Past experience
Anxiety
Rest and Sleep
Attention
Personal and family duties
Value or meaning of pain
Support from others
Culture
Age/illness
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Words Used to Describe Pain
Aching
Burning
Cramping
Crushing
Dull
Gnawing
Knifelike
Piercing
Pressure
Sharp
Sore
Squeezing
Stabbing
Throbbing
Vise-like
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Signs and Symptoms
Location
Onset and Duration
Intensity
Description
Factors causing pain
Vital signs
Other signs and symptoms
On a scale of 1 - 10
10 is the worst
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Nursing Measures for Pain control
Distraction - change the person’s center of attention
Relaxation - free from mental or physical stress
Guided Imagery - creating and focusing on an image
Watch for S&S from drugs used to relieve pain.
Wait 1 hour after pain medicine to
provide assistance with ADLs.
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RestBeing calm, at ease and relaxed
Reading, music, hobbies
You can promote rest by meeting patient’s needs:•Physical
•Safety and security
•Love and belonging
•Self-esteem
Injured or ill people need to rest more often
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Sleep
A state of unconsciousness,reduced voluntary muscle activity and lowered metabolism
A basic need
A person thinks and functions better after sleep
Insomnia – inability to fall asleep or stay asleep.
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Sleep
Two phases of sleep:
NREM – non rapid eye movement. Starting to fall asleep
REM – rapid eye movement. Deep sleep
Need for sleep decreases with
age.
Avg. sleep req. for older adults: 5 – 7 hours
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Factors Effecting Sleep
Illness - need for sleep
Nutrition - sleep needs with weight gain. Foods with caffeine prevent sleep
Exercise - improves health and fitness. Improves sleep
Environment
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Factors Effecting Sleep
Drugs and other substances
Life style changes
Emotional problems - fear, worry, anxiety interfere with sleep
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Nursing Measures to Promote Sleep
Organize care for uninterrupted sleep
Provide comfortable room temp
Avoid caffeineHave the resident void
before bedtimeFollow bedtime rituals
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Nursing Measures to Promote Sleep
Dress in comfortable nightwear
Reduce noiseDarken the roomMake sure linens,
depends are clean & dryPosition in good
alignmentBack massage
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Sleep Walking
Protect the resident from injury
Guide the resident back to bed
Gently wake the resident
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Residents with Dementia
Sleep problems are common
Restlessness & confusion @ night
Allow safe wandering if possible
Redirect to room
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Review
Pain is an objective sign.
True or False
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Review
Person’s with dementia will usually sleep well at night.?
True False
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Review
Pain that is sudden and short lasting is called
____________________Acute pain
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Review
The nurse gave Mr. Johnson a drug for pain. You should wait how long before providing assistance with ADLs?
One hour
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Review
The inability to fall asleep or stay asleep is
___________________________. insomnia
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Review
Feeling pain in a body part that is no longer there:
______________________.Phantom pain
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Review
What is REM sleep?
Rapid eye movement:
deep sleep
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Review
HS
Ad lib
prn
Stat
qod
Hours of sleep
As desired
As needed
immediately
Every other day
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Review
Bid
Tid
C
S
X
Twice a day
Three times a day
with
without
except
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Review
Mr. Marshall has dementia. He cannot tell you that he is in pain. How can you tell?
His behavior will change
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Review
Use the resident’s exact words when reporting pain to the nurse.
True or False
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Review
You find a resident sleepwalking. You should do all of the following except:
A. Protect the resident from injury
B. Guide the resident back to bed
C. Gently wake the resident
D. Turn on the lights
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PiercingPressureSharpSoreSqueezingStabbingThrobbingVise-like
What are some words used to describe pain?
Aching
Burning
Cramping
Crushing
Dull
Gnawing
Knifelike
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Review
Mr. Parker is 72 years old.
He needs approx. ________
hours of sleep each night .
5-7
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Questions??