This document discusses factors that influence comfort and devices that can promote comfort for patients. It defines comfort and comfort devices, then outlines several key factors that can influence a patient's comfort, such as pain, restricted movement, temperature extremes, anxiety, and lack of sleep. It proceeds to describe various comfort devices like pillows, back rests, rolls, foot rests, sand bags, mattresses, rings, cradles, blocks, air cushions, cardiac tables, and trapeze bars that are used to promote comfort, prevent or alleviate discomfort, ensure rest, and maintain correct posture. The overall purpose of comfort devices is to add to a patient's well-being and freedom from physical or mental distress.
This document discusses hot and cold applications for therapeutic purposes. Hot applications are used to relieve pain and congestion, provide warmth, and promote healing by increasing blood flow. Cold applications are used to reduce pain, control bleeding and bacteria growth, and decrease inflammation by constricting blood vessels. Both have specific indications and contraindications. Guidelines are provided for safely applying heat or cold to achieve therapeutic benefits while avoiding potential complications like burns or tissue damage.
Types of bed in Nursing- easy explanation for Student Nurses
CLOSED BED
OPEN BED
ADMISSION BED
OCCUPIED BED
OPERATION BED/POST ANESTHESIA BED/RECOVERY BED
CARDIAC BED
FRACTURE BED
AMPUTATION BED/STUMP BED
BURN BED
The document discusses the principles and procedures of bed making for patients. It outlines that bed making aims to provide a safe, comfortable and hygienic surface for patients while preventing infections and other complications. Key aspects of bed making include proper hand hygiene, removing wrinkles and ensuring bedding is tucked smoothly to prevent pressure sores. Maintaining good body mechanics during bed making is also important to prevent nurse fatigue. Systematic processes should be followed to save time and resources.
The document discusses equipment, linen, and medical supplies used in hospitals. It defines equipment as fixed or portable items used for diagnosis, treatment, and patient care. Linen refers to clothing items like cotton used in hospitals. Medical supplies include consumable and disposable items used for patient treatment. The document outlines the maintenance, cleaning, and sterilization processes for various equipment, linen, glassware, and other supplies to prevent infection and ensure proper functioning.
This document describes 10 different patient positioning techniques including:
1. Supine position - lying on the back with head and shoulders slightly elevated. Used as the usual position.
2. Prone position - lying on the abdomen, used post-operatively or for certain exams/procedures.
3. Lateral position - lying on the side, used for periodic position changes or certain exams/procedures.
It provides the indications, contraindications, and procedures for each position. Patient comfort, safety, and proper alignment are emphasized.
This document discusses body mechanics and mobility. It defines body mechanics as using correct muscles to safely and efficiently complete tasks without strain. Maintaining proper body alignment and mobility is important to avoid health issues. The document outlines principles of body mechanics for various activities like lifting, pushing, pulling and carrying. It also discusses range of motion exercises and factors that can affect body alignment and mobility such as age, injury and disease.
This document defines 10 different patient positioning techniques and their purposes and indications. The positions discussed include supine, prone, lateral, lithotomy, dorsal recumbent, Fowler's, Sims, Trendelenburg, knee-chest, and orthopneic. Each position is defined and the therapeutic reasons for using each position, such as for examinations, procedures, or to relieve pressure, are provided.
This document provides an overview of the nursing process. It begins by outlining the objectives of understanding the nursing process, its characteristics, benefits, and phases. It then defines the nursing process as a modified scientific method used to assess client needs and develop a care plan. The key phases are described as assessment, nursing diagnosis, planning, implementation, and evaluation. Assessment involves collecting client data, nursing diagnosis identifies responses to health issues, planning develops the care approach, implementation provides care, and evaluation assesses effectiveness. The document explains each phase in further detail.
The document discusses various types of materials, equipment, and linen used in hospitals and their care and maintenance. It covers the different categories of equipment including reusable and disposable items. It provides details on the proper cleaning, disinfection, and sterilization techniques for different materials like linen, rubber goods, steel instruments, glass, and plastic items. The document also discusses the care and maintenance of other items like furniture and machinery equipment. It emphasizes the importance of maintaining proper inventory and indent records for materials and ensuring their optimal availability.
This document discusses various comfort devices used to provide comfort to patients. It describes pillows, back rests, hand rolls, foot rests, knee rests, sand bags, air/water mattresses, rubber/cotton rings, bed cradles, bed blocks, air cushions, cardiac tables, side rails, wedge/abductor pillows, and trapeze bars. For each device, it provides details on how it is constructed and its purpose in maintaining patient alignment, reducing pressure, and adding to physical comfort. The overall goal of comfort devices is to enhance patient satisfaction and health outcomes.
Providing safe and clean environment.pptxAnju Kumawat
The document discusses factors that influence the environment for patients, including temperature, ventilation, humidity, lighting, odor, noise, interior design, and pest control. It emphasizes the importance of maintaining a safe, clean, and comfortable environment. The nurse's role is to assess safety risks, orient patients, ensure call lights and items are within reach, and take precautions to prevent accidents like falls through regular toileting, non-skid footwear, and grab bars. The overall goal is to promote patient comfort while minimizing health risks.
This document provides information on caring for dying patients. It discusses assessing patient needs, communicating with patients and families, and meeting physiological, psychological and spiritual needs. It outlines the stages of dying according to Dr. Kubler-Ross and stages of grief. It describes signs that a patient is approaching death and signs of clinical death. It discusses caring for the patient's body after death, including cleaning and preparing the body for the family. The overall message is the importance of providing dignified, compassionate care and supporting patients and families during the dying process.
Bed-making is the act of arranging the bedsheets and other bedding on a bed, to prepare it for use. It is a household chore, but is also performed in establishments including hospitals, hotels, and military or educational residences. Bed-making is also a common childhood chore.
Patient teaching, also known as patient education, involves informing patients to secure informed consent and promote patient compliance. The nurse's role includes assessing learning needs, developing objectives, planning and implementing teaching, evaluating learning, and documenting the process. Key aspects of patient teaching include maintaining health, preventing illness, and teaching patients to manage their condition. The teaching process considers the patient's educational background, health perceptions, and knowledge. Nurse educators must plan teaching appropriately and be available for incidental lessons.
A nurse fulfills many roles including caregiver, clinical decision maker, advocate, case manager, rehabilitator, comforter, communicator, teacher, and leader. As a caregiver, the nurse helps clients regain their health through the healing process and preserves their dignity. As a clinical decision maker, the nurse uses critical thinking and collaborates with the healthcare team and clients. The nurse protects clients, asks about allergies, and ensures their legal and human rights are upheld.
This document discusses the nutritional needs of patients from a nursing perspective. It defines nutrients and their importance for energy, tissue maintenance, and bodily functions. Nutritional needs are affected by various factors like age, activity level, medical conditions, and more. A nutritional assessment evaluates intake, lifestyle, medical history, and includes anthropometric measurements, biochemical tests, clinical exams, and dietary analyses. Nurses play an important role in meeting patients' nutritional needs by considering preferences, assisting with meals, discussing diet importance, and more.
This document discusses the importance of providing a safe and clean physical environment in hospitals. It outlines several factors that contribute to patient safety, comfort, and well-being such as adequate ventilation, appropriate temperature and humidity levels, noise control, clean water supply, and evacuation plans for emergencies. Maintaining proper sanitation and hygiene is also emphasized, including regular cleaning, pest control, and ensuring food safety standards in the hospital kitchen. The overall goal is to minimize health risks and create an atmosphere that promotes recovery for patients.
Body mechanics, mobility and body alignment introductionArifa T N
This document discusses mobility, body alignment, and body mechanics. It defines mobility as body movement requiring coordination between musculoskeletal and nervous systems. Body alignment refers to proper joint, ligament, and muscle positioning when standing, sitting, or lying down. Body mechanics is the safe use of the body through correct posture, balance, and movement to safely lift and move objects and people. Maintaining proper body alignment and mechanics is important for physiological function, injury prevention, and nursing care safety.
This document discusses sleep and rest patterns. It defines sleep and rest, compares their characteristics, and identifies the stages of non-REM and REM sleep. The document outlines functions of sleep, factors that affect sleep, and common sleep disorders. It also discusses conditions necessary to promote sleep and the nursing process for patients.
This document discusses sleep and rest. It defines rest and sleep, describes the stages of sleep including NREM and REM sleep. It discusses factors that affect sleep like age, illness, environment. Common sleep alterations like insomnia, sleep apnea, and parasomnias are explained. Nursing responsibilities for assessing, planning, implementing and evaluating care to promote sleep and rest are outlined.
This document discusses sleep disturbances and patterns. It begins with objectives of gaining knowledge about sleep disturbances, patterns, and their application in patient care. It then covers definitions of sleep, sleep facts, sleep patterns in different age groups, sleep physiology including stages of sleep and sleep regulation. Factors affecting sleep and consequences of sleep deprivation are explained. Common sleep disorders like insomnia are described along with international classification of sleep disorders and their management.
Indian philosophy posits three states of consciousness: waking, dreaming, and deep sleep. These states correspond to the gross, subtle, and causal bodies respectively. Several ancient Upanishads discuss states of consciousness including awake, dream-filled sleep, deep sleep, and beyond deep sleep. There are four types of brain waves - beta, alpha, theta, and delta - which occur during different stages of wakefulness and sleep. Sleep stages progress from light to deep sleep, consisting of NREM stages 1-3 and REM sleep. Neurotransmitters like acetylcholine and hormones like melatonin regulate the sleep-wake cycle which is controlled by the circadian rhythm in the hypothalamus. DNA repair occurs more during sleep, reducing
Sleep is a state of sustained immobility, reduced responsiveness, and characteristic posture that allows the body to rest and repair itself. It is essential for humans and most animals. Lack of sufficient sleep can impair functions like alertness, learning, mood, energy levels, and coordination. Brain waves change during sleep cycles from beta/alpha when awake to theta/delta when asleep. Sleep consists of REM and non-REM sleep, with dreaming occurring in REM sleep. Establishing good sleep habits and avoiding stimulants before bed can help improve sleep quality and duration.
This document discusses concepts related to sleep and rest. It defines sleep and rest, compares their characteristics, and describes the two types of sleep - NREM and REM sleep. The document outlines objectives, functions of sleep, factors affecting sleep, common sleep disorders like insomnia and sleep apnea, and nursing interventions to promote sleep. Nursing diagnoses and safety measures for patients with sleep issues are also mentioned.
Sleep progresses through distinct stages in a cycle. Non-REM sleep begins with light sleep in stages 1 and 2, characterized by theta waves and sleep spindles. Stages 3 and 4 involve deep sleep with synchronized brain activity appearing as delta waves. REM sleep involves dreaming and similar brain activity to wakefulness. The circadian rhythm and homeostatic processes regulate sleep cycles, with the circadian rhythm promoting wakefulness opposed by the increasing homeostatic drive for sleep with time spent awake.
The document discusses sleep needs at different ages, sleep disorders, circadian rhythms, and the stages of sleep. Infants need 12-18 hours of sleep per night, children ages 5-10 need 10-11 hours, and teens and adults need 8-9 hours and 7-9 hours respectively. Sleep disorders include insomnia, sleep apnea, REM sleep behavior disorder, restless legs syndrome, and narcolepsy. Circadian rhythms regulate the sleep-wake cycle through exposure to light and darkness. Sleep cycles through NREM and REM stages with different brain wave patterns in each stage.
This document discusses the importance of rest for the body and mind. It notes that Jesus recognized the need for his disciples to take time away from their busy schedules to rest. The document then discusses the stages of sleep and why sleep is important for physical and mental restoration. It notes that lack of sleep can impair memory, concentration, immune function and more. Finally, it provides tips on promoting good sleep habits and highlights that the Sabbath was created by God as a day of rest.
This document discusses the importance of sleep and provides information about sleep stages and cycles. It defines sleep and discusses how sleep changes throughout life. The stages of sleep include stage 1, 2, 3 and REM sleep. A normal sleep cycle takes 90-120 minutes and includes progression through the stages before REM sleep. Deep sleep occurs in stage 3. Dreams typically occur during REM sleep. The benefits of good sleep for health are also outlined, including keeping the heart healthy, reducing stress, and improving memory and weight control.
Dr. Suresh Kumar Murugesan is a professor and researcher in psychology from Madurai, India. He specializes in areas like psychotherapy, positive psychology, education psychology, and cyber psychology. The presentation discusses sleep, explaining that it is essential for survival and important for brain functions. It describes the different stages of sleep - stages 1 to 4 of non-REM sleep and REM sleep. Brain structures like the hypothalamus, brain stem, and pineal gland are involved in regulating sleep cycles. Sleep is controlled by circadian rhythms and homeostasis. Lack of quality sleep can increase health risks like high blood pressure and depression. The document also covers brain waves and the different frequency bands measured during different states of
This document defines and discusses sleep patterns, types of sleep, functions of sleep, factors affecting sleep, and common sleep disorders. It begins by defining rest and sleep and comparing their characteristics. There are two main types of sleep: non-rapid eye movement sleep (NREM) which has three stages, and rapid eye movement (REM) sleep. Key functions of sleep include energy conservation, thermoregulation, brain function, memory consolidation, and physical health benefits. Factors affecting sleep include age, illness, environment, lifestyle, emotional stress, and drugs/substances. Common sleep disorders discussed are insomnia, parasomnia, and narcolepsy. Conditions to promote healthy sleep are also outlined.
This document provides an overview of concepts related to sleep including definitions of sleep and rest, the two types of sleep (NREM and REM), sleep cycles and stages, factors that affect sleep, functions of sleep, and common sleep disorders. It also discusses nursing assessments of sleep and potential nursing diagnoses and interventions to promote healthy sleep.
This document defines sleep and rest, compares their characteristics, and discusses sleep patterns and disorders. It outlines two types of sleep - NREM and REM sleep - and explains their stages and functions. Factors affecting sleep and common sleep disorders like insomnia and sleep apnea are identified. Nursing interventions to promote sleep through environmental changes, relaxation techniques, and medication administration if needed are also discussed.
The fund aims to provide financial support to small businesses and entrepreneurs who are just starting out or expanding their operations. It will offer loans and grants of up to $50,000 to eligible applicants looking to start a new business or grow an existing one. Priority will be given to applicants operating in rural areas, women-owned businesses, and businesses promoting environmentally sustainable practices.
This document discusses the importance of sleep for health. It describes the five stages of sleep, including rapid eye movement (REM) sleep and non-REM sleep. Insufficient sleep can increase risks for various diseases like obesity, diabetes, and heart disease due to changes in hormones like ghrelin and leptin. Getting 7-9 hours of sleep per night is recommended to maintain good health and reduce risks.
The document discusses fatigue experienced by seafarers working irregular schedules. It covers three main points: 1) Causes of fatigue include irregular work schedules, environmental factors, and personal health issues which disrupt circadian rhythms and reduce sleep quality and quantity. 2) Fatigue impairs cognitive abilities and increases risk of errors and microsleep. Signs include heavy eyes and slurred speech. 3) Irregular schedules reduce total sleep time, leading to performance declines especially at night, increasing risks of accidents similar to patterns seen in road accidents. Maintaining adequate, regular sleep is important to prevent building up a sleep debt and fatigue.
Sleep is essential for normal functioning and survival. It helps the body and brain restore and repair. There are different sleep stages that provide different benefits. Most adults need 7-9 hours of sleep per night, though individual needs vary. Lack of sufficient sleep can seriously impair performance and health, increasing risks of accidents, illness, and mental health issues.
The outcome of this course is for the learner to describe the normal stages of sleep, common sleep measurement tools sleep characteristic, common sleep disorders, the changes that affect the quality and quantity of sleep as an individual ages, and methods the healthcare provider can use to assess and assist clients with sleep disorders.
Stewart scott 3rd_period_english_4_sleep_whatmrsalcido
Sleep has 5 stages that make up non-REM sleep and REM sleep. It rejuvenates the body physically, mentally, and emotionally by allowing the body to heal and the brain to consolidate memories. Not getting enough sleep can lead to issues like obesity, sickness, and even death in severe cases, as it impacts functions like temperature regulation and immune response. Proper sleep is important for physical and mental health.
Similar to Rest, Sleep and Comfort measures.pptx (20)
Community resources are defined as any assets that can be used to meet health needs and include human, financial, material, and time resources. Key human resources are health workers, volunteers, and community organizations, while financial resources include funds from governments and organizations. Material resources encompass physical infrastructure, supplies, and land donations. Proper identification, allocation, and use of available community resources are vital for effective healthcare provision.
The document outlines the key components of community diagnosis, which include demography, causes of mortality and morbidity, use of health services, nutrition, society and culture, leadership patterns, mental health, environment, and knowledge/attitudes/practices of the population regarding health. It also describes the methods and techniques used in community diagnosis, such as identifying problems/needs/resources through primary and secondary data collection, and the steps involved, including developing definitions, collecting background information, selecting communities, data collection/analysis, and prioritizing health needs and actions.
This document discusses community diagnosis and its importance. It defines community diagnosis as a comprehensive assessment of a community's health status and the social, economic, and environmental factors that influence it. The key components of community diagnosis are identifying health problems, mortality and morbidity rates, and factors that put people at risk. It differs from clinical diagnosis by examining the community as a whole rather than individuals. Community diagnosis is important as it helps identify needs, determine available resources, set priorities, and plan, implement and evaluate community health programs. It aims to understand the magnitude of health issues and how they are changing.
This document defines and classifies wounds and wound drainage. It discusses the process of wound healing, which involves inflammatory, proliferative and maturation phases. Factors that can influence wound healing include nutrition, tissue perfusion, infection and age. Wound management strategies involve moist wound healing, preventing infection, nutrition/fluids, positioning and preventing pressure ulcers. Complications of wound healing include hemorrhage, infection, dehiscence and evisceration.
This document provides information on wound dressing, irrigation, and bandaging. It defines each term and describes the purposes, principles, procedures, types of materials used, and techniques for dressing wounds, irrigating wounds, and applying bandages. Dressings are used to protect and aid in healing wounds, while irrigation helps clean wounds and bandages are used to support, immobilize, and secure dressings over wounds or injured body parts. The document outlines best practices and sterile techniques for each procedure.
Patient positioning involves properly maintaining a patient's neutral body alignment to prevent complications from immobility or injury. There are several positions used in patient care like supine, lateral, prone, and lithotomy positions. Factors like the patient's needs, abilities, disease, and hospital protocols must be considered when positioning. Positioning aims to provide comfort, relieve pressure, improve circulation, prevent deformities, and allow for interventions. Proper techniques and safety measures are followed to position patients in a systematic way.
The document discusses rehabilitation nursing. It begins by defining rehabilitation as the restoration of normal life through retraining and medical treatment after illness or impairment. Rehabilitation nursing aims to restore abilities to the highest level of function, prevent further disability, protect existing abilities, and assist present abilities.
Rehabilitation involves a team approach including nurses, physical therapists, occupational therapists, and others. It can be institution-based in hospitals or community-based using local resources. Community-based rehabilitation focuses on enhancing quality of life and involves the community, families, and disabled individuals. The role of nurses in rehabilitation includes assessment, care planning, implementation, and evaluation to improve functioning and independence.
This document provides information on lobbying, critical thinking, and decision making. It defines lobbying as attempting to influence political decisions through advocacy, and identifies three types of lobbyists. It outlines steps for effective lobbying campaigns and letter writing, including developing a plan, understanding opposing views, and following up. The document also defines critical thinking as actively conceptualizing and evaluating information to guide beliefs and actions. It describes Bloom's six levels of critical thinking and the five stages of developing critical thinking skills from unreflective to habitually high-level across domains.
More from Lumbini Medical College and Teaching Hospital, Nursing Program (9)
Co-Chairs, Hussein Tawbi, MD, PhD, and Prof. Christian Blank, MD, PhD, discuss melanoma in this CME activity titled “Deploying the Immune GAMBIT Against Melanoma: Guidance on Advances and Medical Breakthroughs With ImmunoTherapy.” For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at https://bit.ly/4edfNpE. CME credit will be available until July 5, 2025.
Osvaldo Bernardo Muchanga- MALE CIRCUMCISION, ITS Vs SOCIOCULTURAL BELIEFS (C...Osvaldo Bernardo Muchanga
MALE CIRCUMCISION consists of the surgical act of removing the foreskin (skin that covers the glans of the penis), leaving the glans more prominent and better cleanable.
MALE CIRCUMCISION itself has medical as well as sociocultural implications, as it has been proven to be an act that can minimize SEXUALLY TRANSMITTED INFECTIONS (STIs), especially HIV, but it also represents the SOCIOCULTURAL IDENTITY of some people, respectively.
Now, in a SERO-EPIDEMIOLOGICAL PROFILE like that of Mozambique where the prevalence of HIV is around 12.5% which corresponds to approximately 2 million people living with HIV, where the province of GAZA is the most seroprevalent with a positivity rate of 21% (INSIDA, 2021), it is extremely necessary to THOROUGHLY scrutinize all possibilities for preventing or minimizing the spread of HIV and other STIs.
This document contains an overview of different types of ocular neoplastic disorders or ocular tumors among pediatric patients. you can have a quick basic concept about ocular tumors among children and a basic management strategy. You will have perfect idea about almost 8 ocular tumors among pediatric patients .
Are you ready to reap the benefits of this best magnesium supplement now? Visit us today to learn more about its health and vitality benefits.
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Human blood has a hydrogen ion concentration [H+ ] of 35 to 45 nmol/L and it is essential that its concentration is maintained within this narrow range.
Hydrogen ions are nothing but protons which can bind to proteins and alter their characteristics.
All the enzymes present in the body are proteins and an alteration in these enzyme systems can change the homeostatic mechanisms of the body.
Hence, a disturbance in acid-base balance can result in malfunction of the various organ systems.
The normal pH of blood is 7.35-7.45.
Acidosis is defined as a pH Less than 7.35.
Conversely, when the pH is more than 7.45, alkalosis is said to exist.
Acidosis and alkalosis are of two types each: respiratory and metabolic.
An increase in carbon dioxide (CO2 ) levels increases the plasma [H+ ] and decreases the pH (respiratory acidosis).
Similarly, a decrease in plasma carbon dioxide levels reduces the [H+ ] and increases the pH (respiratory alkalosis).
A decrease in [HC03 -] reduces the pH and is called metabolic acidosis.
Similarly, an increase in [HC03 -] increases the pH and produces metabolic alkalosis.
The pH is regulated in the human body mainly by two organs: the respiratory system and the renal system.
The arterial carbon dioxide levels are regulated by the respiratory system.
Any increase in carbon dioxide levels stimulates the respiratory centre in the medulla thus augmenting respiration, alveolar ventilation and elimination of extra CO2 levels.
A decrease in CO2 levels may reduce the stimulus to breathe and cause hypoventilation.
This response is limited by hypoxia as the hypoxic drive stimulates the patient to maintain respiration.
Respiratory response to changes in CO2 level occurs very fast.
The plasma bicarbonate levels are regulated by the kidneys.
Any decrease in [HC03 -] stimulates the kidney to retain and synthesise bicarbonate.
High [HC03 -] results in elimination of more bicarbonate in urine.
In general, the pulmonary response to a change in acid-base status is faster and occurs immediately.
However, renal regulation takes time, a few hours to days.
Kidneys filter and reabsorb all the bicarbonate in the urine.
When necessary, kidneys can also produce extra bicarbonate through the glutamine pathway.
When an acid-base disorder occurs, the initial disturbance that occurs is termed the primary disorder.
The body attempts to normaliZe the pH by certain compensatory mechanisms resulting in a secondary disorder, e.g. primary metabolic acidosis results in an increase in hydrogen ions and a consequent decrease in bicarbonate ions.
To compensate for this, the patient hyperventilates and reduces the arterial carbon dioxide levels, thus moving the pH back to normal ( compensatory respiratory alkalosis )
General Endocrinology and mechanism of action of hormonesMedicoseAcademics
This presentation, given by Dr. Faiza, Assistant Professor of Physiology, delves into the foundational concepts of general endocrinology. It covers the various types of chemical messengers in the body, including neuroendocrine hormones, neurotransmitters, cytokines, and traditional hormones. Dr. Faiza explains how these messengers are secreted and their modes of action, distinguishing between autocrine, paracrine, and endocrine effects.
The presentation provides detailed examples of glands and specialized cells involved in hormone secretion, such as the pituitary gland, pancreas, parathyroid gland, adrenal medulla, thyroid gland, adrenal cortex, ovaries, and testis. It outlines the special features of hormones, differentiating between peptides and proteins based on their amino acid composition.
Key principles of endocrinology are discussed, including hormone secretion in response to stimuli, the duration of hormone action, hormone concentrations in the blood, and secretion rates. Dr. Faiza highlights the importance of feedback control in hormone secretion, the occurrence of hormonal surges due to positive feedback, and the role of the suprachiasmatic nucleus (SCN) of the hypothalamus as the master clock regulating rhythmic patterns in biological clocks of neuroendocrine cells and endocrine glands.
The presentation also addresses the metabolic clearance of hormones from the blood, explaining the mechanisms involved, such as metabolic destruction by tissues, binding with tissues, and excretion by the liver and kidneys. The differences in half-life between hydrophilic and hydrophobic hormones are explored.
The mechanism of hormone action is thoroughly covered, detailing hormone receptors located on the cell membrane, in the cell cytoplasm, and in the cell nucleus. The processes of upregulation and downregulation of receptors are explained, along with various types of hormone receptors, including ligand-gated ion channels, G protein–linked hormone receptors, and enzyme-linked hormone receptors. The presentation elaborates on second messenger systems such as adenylyl cyclase, cell membrane phospholipid systems, and calcium-calmodulin linked systems.
Finally, the methods for measuring hormone concentrations in the blood, such as radioimmunoassay and enzyme-linked immunosorbent assays (ELISA), are discussed, providing a comprehensive understanding of the tools used in endocrinology research and clinical practice.
Introduction of mental health nursing, Perspective of mental health and mental health nursing, Evolution of mental health services, treatment and nursing practices Mental health team, Nature and scope of mental health nursing, Role & function of mental health nurse inn various settings and factors affecting the level of nursing practice, concept of normal and abnormal behavior
- Video recording of this lecture in English language: https://youtu.be/AWaobASkZM4
- Video recording of this lecture in Arabic language: https://youtu.be/1cQRmJ3SKWc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
The Revolutionary Nature of Needleless Double Transfer Spikes in HealthcareNanchang Kindly Meditech
It's likely that you have witnessed medical personnel using needles to transmit fluids or medicines if you have ever visited a hospital or other healthcare facility. But as technology advances, needleless double transfer spikes are becoming more and more common and revolutionizing the delivery of healthcare.
Definition of mental health nursing, terminology, classification of mental disorder, ICD-10, Indian Classification, Personality development, defense mechanism, etiology of bio psychosocial factors,
Regenerative Medicine in Chronic Pain ManagementReza Aminnejad
Regenerative technologies are the future of medicine. The current clinical strategy focuses primarily on treating the symptoms but regenerative medicine seeks to replace tissue or organs that have been damaged by age, disease, trauma, or congenital issues.
2. Course content
★ Definition of rest and sleep
★ Physiology , types, cycles and function of sleep
★ Normal patterns of sleep and requirement
★ Factors affecting sleep
★ Common sleep disorders
★ Nursing management for promotion of sleep
3. Contd…
★ Comfort measures
❖ Bed making; purposes, types and procedure of
bed making
❖ Back care and back massage
❖ Positioning of client
4. Introduction
Sleep is a basic human need; it is a universal
biologic process common to all people. Humans
spend about one third of their lives asleep.
5. Contd…
We require sleep for many reasons:
➔to cope with daily stresses,
➔to prevent fatigue, to conserve energy,
➔to restore the mind and body, and
➔to enjoy life more fully.
6. Contd…
Sleep enhances daytime functioning, and is vital
for cognitive, physiological, and psychosocial
function (Gruber, 2013).
7. Contd…
Sleep is an important factor in a person’s quality of
life, yet sleep disorders and sleep deprivation are
an unmet public health problem, as reported by the
Centers for Disease Control and Prevention (CDC)
(2014).
8. Definition of rest and sleep
Rest :cease work or movement in order to relax,
sleep, or recover strength.
Sleep is a cyclical physiological process that
alternates with longer periods of wakefulness. The
sleep-wake cycle influences and regulates
physiological function and behavioral responses.
9. Physiology of sleep
More recently, sleep has come to be considered an
altered state of consciousness in which the
individual’s perception of and reaction to the
environment are decreased.
10. Contd…
Sleep is characterized by minimal physical activity,
variable levels of consciousness, changes in the
body’s physiological processes, and decreased
responsiveness to external stimuli.
11. Contd…
Some environmental stimuli, such as a smoke
detector alarm, will usually awaken a sleeper,
whereas many other noises will not.
It appears that individuals respond to meaningful
stimuli while sleeping and selectively disregard non
meaningful stimuli. For example, a mother may
respond to her baby’s crying but not to the crying of
another baby.
12. Contd…
The upper part of the reticular formation consists of
a network of ascending nerve fibers called the
reticular activating system (RAS), which is
involved with the sleep/wake cycle.
An intact cerebral cortex and reticular formation
are necessary for the regulation of sleep and waking
states.
14. Contd…
Neurotransmitters, located within neurons in the
brain, affect the sleep/wake cycles.
For example, serotonin is thought to lessen the
response to sensory stimulation and gamma-
aminobutyric acid (GABA) to shut off the activity in
the neurons of the reticular activating system.
15. Contd…
Another key factor to sleep is exposure to
darkness.
Darkness and preparing for sleep (e.g., lying down,
decreasing noise) cause a decrease in stimulation
of the RAS.
16. Contd…
During sleep, the growth hormone is secreted and
cortisol is inhibited.
With the beginning of daylight, melatonin is at its
lowest level in the body and the stimulating
hormone, cortisol, is at its highest.
17. Contd…
During this time, the pineal gland in the brain
begins to actively secrete the natural hormone
melatonin, and the person feels less alert.
Wakefulness is also associated with high levels of
acetylcholine, dopamine, and noradrenaline.
18. Contd…
Acetylcholine is released in the reticular formation,
dopamine in the midbrain, and noradrenaline in the
pons.
These neurotransmitters are localized within the
reticular formation and influence cerebral cortical
arousal.
19. Circadian Rhythm
Biologic rhythms exist in plants, animals, and
humans. In humans, these are controlled from within
the body and synchronized with environmental
factors, such as light and darkness.
20. Contd…
The most familiar biologic rhythm is the circadian
rhythm. It is a sort of 24-hour internal biological
clock.
The term circadian is from the Latin “circa dies”,
meaning “about a day.”
21. Contd…
Although sleep and waking cycles are the best
known of the circadian rhythms, body temperature,
blood pressure, and many other physiological
functions also follow a circadian pattern.
22. Contd…
Sleep is a complex biologic rhythm. When a
person’s biologic clock coincides with the
sleep/wake cycles, the person is said to be in
circadian synchronization; that is, the person is
awake when the body temperature is highest, and
asleep when the body temperature is lowest.
23. Contd…
Circadian regularity begins to develop by the sixth
week of life, and by 3 to 6 months most infants have
a regular sleep/wake cycle.
26. Types of Sleep
The two types of sleep are
1. NREM (non–rapid-eye-movement) sleep and
2. REM (rapid-eye-movement) sleep
During sleep, NREM and REM sleep alternate in
cycles.
27. NREM sleep
In the classical definition of NREM sleep, people
progress through four stages during a typical 90-
minute sleep cycle.
The American Academy of Sleep Medicine defines
three stages in NREM sleep, combining stages 3
and 4.
28. REM sleep
REM sleep is the phase at the end of each 90-
minute sleep cycle.
During REM sleep there is increased brain activity
associated with rapid eye movements and muscle
atonia.
29. Stages of the Sleep Cycle
1. NREM, Non rapid eye movement;
2. REM, rapid eye movement.
30. NREM (75% of Night)
N1 (Formerly Stage 1)
• Stage of lightest level of sleep, lasting a few
minutes.
• Decreased physiological activity begins with
gradual fall in vital signs and metabolism.
• Sensory stimuli such as noise easily arouse
sleeper.
• If awakened, person feels as though daydreaming
has occurred.
31. Contd…
N2 (Formerly Stage 2)
• Stage of sound sleep during which relaxation
progresses.
• Arousal is still relatively easy.
• Brain and muscle activity continue to slow.
32. Contd…
N3 (Formerly Stages 3 and 4)
• Called slow-wave sleep.
• Deepest stage of sleep.
• Sleeper is difficult to arouse and rarely moves.
• Brain and muscle activity are significantly
decreased.
• Vital signs are lower than during waking hours.
33. REM Sleep (25% of Night)
• Vivid, full-color dreaming occurs.
• Stage usually begins about 90 minutes after sleep
has begun.
• Stage is typified by autonomic response of rapidly
moving eyes, fluctuating heart and respiratory rates,
and increased or fluctuating blood pressure.
34. Contd…
• Loss of skeletal muscle tone occurs.
• Gastric secretions increase.
• It is very difficult to arouse sleeper.
• Duration of REM sleep increases with each cycle
and averages 20 minutes
35. Sleep Cycle
Normally an adult’s routine sleep pattern begins with
a pre sleep period during which the person is
aware only of a gradually developing sleepiness.
This period normally lasts 10 to 30 minutes.
36. Contd…
Individuals who have trouble falling asleep often
remain in this stage for an hour or more.
Once asleep a person usually passes through four
to six complete sleep cycles, each cycle
consisting of three stages of NREM sleep and a
period of REM sleep, for a total of 90 to 110
minutes.
37. Contd…
With each successive cycle, stage 3 (combined 3
and 4) of NREM sleep shortens, and REM sleep
lengthens.
REM sleep lasts up to 60 minutes during the last
sleep cycle.
Not all people progress consistently through the
usual stages of sleep.
40. Contd…
For example, a sleeper fluctuates back and forth for
short intervals between NREM stages 2, and 3
before entering REM sleep. The amount of time
spent in each stage varies. The number of sleep
cycles depends on the total amount of time that the
person spends sleeping.
41. Function of sleep
➢ Sleep exerts physiological effects on both the
nervous system and other body structures.
➢ Sleep in some way restores normal levels of
activity and normal balance among parts of the
nervous system.
42. Contd…
➢ Sleep is also necessary for protein synthesis,
which allows repair processes to occur.
➢ The role of sleep in psychological well-being is
best noticed by the deterioration in mental
functioning related to sleep loss.
43. Contd…
➢ Individuals with inadequate amounts of sleep
tend to become emotionally irritable, have poor
concentration, and experience difficulty making
decisions.
44. Normal patterns of sleep and
requirement
Although it used to be believed that maintaining a
regular sleep/wake rhythm is more important than
the number of hours actually slept, recent research
has shown that sleep deprivation is associated with
significant cognitive and health problems.
45. Contd…
Although reestablishing the sleep/wake rhythm (e.g.,
after the disruption of surgery) is important, it is
appropriate to allow and encourage daytime napping
in hospitalized clients.
46. Contd…
❏ Newborns sleep 12 to 18 hours a day, on an
irregular schedule with periods of 1 to 3 hours
spent awake.
❏ At the end of the first year, an infant usually takes
two naps per day and should get about 9 to 12
hours of sleep in 24 hours.
47. Contd…
❏ The school-age child (5 to 12 years of age) needs
10 to 11 hours of sleep per night, but most
receive less because of increasing demands
(e.g., homework, sports, social activities).
❏ Between 12 and 14 hours of sleep are
recommended for children 1 to 3 years of age.
48. Contd…
❏ The preschool-age child (3 to 5 years of age)
requires 11 to 13 hours of sleep per night,
particularly if the child is in preschool.
❏ Adolescents (12 to 18 years of age) require 9 to
10 hours of sleep each night; however, few
actually get that much sleep.
49. Contd…
❏ A hallmark change with age is a tendency toward
earlier bedtime and wake times. Older adults (65
to 75 years) usually awaken 1.3 hours earlier and
go to bed approximately 1 hour earlier than
younger adults (ages 20 to 30).
52. Illness
Illness that causes pain or physical distress (e.g.,
arthritis, back pain) can result in sleep problems.
Certain endocrine disturbances can also affect
sleep. Hyperthyroidism lengthens presleep time,
making it difficult for a client to fall asleep.
Hypothyroidism, conversely, decreases stage 3
sleep.
53. Environment
Environment can promote or hinder sleep. The
person must be able to achieve a state of relaxation
prior to entering a period of sleep.
Any change—for example, noise in the
environment—can inhibit sleep. The absence of
usual stimuli or the presence of unfamiliar stimuli
can prevent people from sleeping
54. Lifestyle
Following an irregular morning and nighttime
schedule can affect sleep. Moderate exercise in the
morning or early afternoon usually is conducive to
sleep, but exercise late in the day can delay sleep.
55. Contd…
The person’s ability to relax before retiring is an
important factor affecting the ability to fall asleep. It
is best, therefore, to avoid doing homework or office
work before or after getting into bed.
56. Emotional Stress
Stress is considered by most sleep experts to be the
one of the greatest causes of difficulties in falling
asleep or staying asleep.
Anxiety increases the norepinephrine blood levels
through stimulation of the sympathetic nervous
system. This chemical change results in less deep
and REM sleep and more stage changes and
awakenings.
57. Stimulants and Alcohol
Caffeine-containing beverages act as stimulants of
the central nervous system (CNS). Drinking
beverages containing caffeine in the afternoon or
evening may interfere with sleep.
Alcohol disrupts REM sleep, although it may hasten
the onset of sleep.
58. Diet
Dietary L-tryptophan—found, for example, in cheese
and milk—may induce sleep, a fact that might
explain why warm milk helps some people get to
sleep.
59. Smoking
Nicotine has a stimulating effect on the body, and
smokers often have more difficulty falling asleep
than nonsmokers.
60. Motivation
Motivation can increase alertness in some situations
(e.g., a tired person can probably stay alert while
attending an interesting concert or surfing the web
late at night). Motivation alone, however, is usually
not sufficient to overcome the normal circadian drive
to sleep during the night.
61. Contd…
Nor is motivation sufficient to overcome sleepiness
due to insufficient sleep. A combination of boredom
and lack of sleep can contribute to feeling tired.
62. Medications
Some medications affect the quality of sleep. Most
hypnotics can interfere with deep sleep and
suppress REM sleep.
Beta-blockers have been known to cause
insomnia and nightmares.
63. Contd…
Narcotics, such as morphine, are known to
suppress REM sleep and to cause frequent
awakenings and drowsiness.
Tranquilizers interfere with REM sleep. Although
antidepressants suppress REM sleep, this effect is
considered a therapeutic action.
64. Drugs That Disrupt Sleep
These drugs may disrupt REM sleep, delay onset of
sleep, or decrease sleep time:
• Alcohol •
Caffeine
• Amphetamines •
Decongestants
• Antidepressants • Narcotics
• Beta-blockers • Steroids
• Bronchodilators
65. Drugs That May Cause
Excessive Daytime Sleepiness
• Antidepressants
• Antihistamines
• Beta-blockers
• Narcotics
67. Insomnia
Insomnia is described as the inability to fall asleep
or remain asleep. Individuals with insomnia do not
awaken feeling rested.
Acute insomnia lasts one to several nights and is
often caused by personal stressors or worry.
If the insomnia persists for longer than a month, it
is considered chronic insomnia.
68. Excessive Daytime Sleepiness
Clients may experience excessive daytime
sleepiness as a result of hypersomnia, narcolepsy,
sleep apnea, and insufficient sleep.
69. Hypersomnia
Hypersomnia refers to conditions where the
affected individual obtains sufficient sleep at
night but still cannot stay awake during the day.
Hypersomnia can be caused by medical conditions,
for example, CNS damage and certain kidney, liver,
or metabolic disorders, such as diabetic acidosis and
hypothyroidism
70. Narcolepsy
Narcolepsy is a disorder of excessive daytime
sleepiness caused by the lack of the chemical
hypocretin in the area of the CNS that regulates
sleep.
71. Sleep apnea
Sleep apnea is characterized by frequent short
breathing pauses during sleep. Although all
individuals have occasional periods of apnea during
sleep, more than five apneic episodes or five
breathing pauses longer than 10 seconds per hour is
considered abnormal and should be evaluated by a
sleep medicine specialist.
72. Contd…
Symptoms suggestive of sleep apnea include loud
snoring, frequent nocturnal awakenings, excessive
daytime sleepiness, difficulties falling asleep at night,
morning headaches, memory and cognitive
problems, and irritability.
73. Contd…
Three common types of sleep apnea are
obstructive apnea, central apnea, and mixed
apnea.
Obstructive apnea occurs when the structures of
the pharynx or oral cavity block the flow of air. The
person continues to try to breathe; that is, the chest
and abdominal muscles move.
75. Contd…
Depending on the severity and chronicity of this
voluntary, albeit unintentional sleep deprivation,
individuals may develop attention and concentration
deficits, reduced vigilance, distractibility, reduced
motivation, fatigue, malaise, and occasionally
diplopia and dry mouth.
76. Parasomnia
A parasomnia is behavior that may interfere with
sleep and may even occur during sleep.
It is characterized by physical events such as
movements or experiences that are displayed as
emotions, perceptions, or dreams.
78. Assessing
A complete assessment of a client’s sleep difficulty
includes a sleep history, health history, physical
exam, and, if warranted, a sleep diary and
diagnostic studies.
All nurses, however, can take a brief sleep history
and educate their clients about normal sleep.
79. Contd…
Sleep History
A brief sleep history, which is usually part of the
comprehensive nursing history, should be
obtained for all clients entering a health care facility.
It should, however, be deferred or omitted if the
client is critically ill.
80. Key questions to ask include the following:
● When do you usually go to sleep?
● And when do you wake up?
● Do you nap?
● If so, when?
If the client is a child, it is also important to ask about
bedtime rituals.
81. Contd…
● Do you have any problems with your sleep?
● Has anyone ever told you that you snore loudly or
thrash around a lot at night?
● Are you able to stay awake at work, when driving,
or engaging in your usual activities?
82. Health History
A health history is obtained to rule out medical or
psychiatric causes of the client’s difficulty sleeping.
It is important to note that the presence of a
medical or psychiatric illness (e.g., depression,
Parkinson’s disease, Alzheimer’s disease, or
arthritis) does not preclude the possibility that a
second problem (e.g., obstructive sleep apnea) may
be contributing to the difficulty sleeping.
83. Contd…
Because medications can frequently cause or
exacerbate sleep disturbances, information should
be obtained about all of the prescribed and
nonprescription medications, including herbal
remedies, that a client consumes.
84. Physical Examination
Rarely are sleep abnormalities noted during the
physical examination unless the client has
obstructive sleep apnea or some other health
problem.
85. Contd…
Common findings among clients with sleep apnea
include an enlarged and reddened uvula and soft
palate, enlarged tonsils and adenoids (in
children), obesity (in adults), and in male clients a
neck size greater than 17.5 inches.
Occasionally a deviated septum may be noted, but
it is rarely the cause of obstructive sleep apnea.
87. Sleep Diary
A sleep specialist may ask clients to keep a sleep
diary or log for 1 to 2 weeks in order to get a more
complete picture of their sleep complaints.
88. Contd…
A sleep diary may include all or selected aspects of
the following information that pertain to the client’s
specific problem:
89. Contd…
• Time of
(a) going to bed,
(b) trying to fall asleep,
(c) falling asleep (approximate time),
(d) any instances of waking up and duration of these
periods,
(e) waking up in the morning, and
(f) any naps and their duration
90. Contd…
• Activities performed 2 to 3 hours before bedtime
(type, duration, and time)
• Consumption of caffeinated beverages and alcohol
and amounts of those beverages
• Any prescribed medications, OTC medications,
and herbal remedies taken during the day
91. Contd…
• Bedtime rituals before sleep
• Any difficulties remaining awake during the day
and times when difficulties occurred
• Any worries that the client believes may affect
sleep
• Factors that the client believes have a positive or
negative effect on sleep
92. Contd…
If the client is a child, the sleep diary or log may be
completed by a parent.
93. Diagnostic Studies
Diagnostic Studies Sleep is measured objectively in
a sleep disorder laboratory by polysomnography
(Sleep Study that monitors several parameters to
diagnose sleep disorders) in which an
electroencephalogram (EEG), electromyogram
(EMG), and electro-oculogram (EOG) are recorded
simultaneously.
94. Contd…
Electroenchephalogram: An electroencephalogram
(EEG) is a test that detects electrical activity in
your brain using small, metal discs (electrodes)
attached to your scalp.
Electromyography (EMG) is a diagnostic
procedure to assess the health of muscles and
the nerve cells that control them (motor neurons).
95. Contd…
Electrooculography (EOG) is a technique for
measuring the corneo-retinal standing potential
that exists between the front and the back of the
human eye. The resulting signal is called the
electrooculogram.
100. Diagnosis
Insomnia, the NANDA (The North American Nursing
Diagnosis Association) International (Herdman &
Kamitsuru, 2014) diagnosis given to clients with
sleep problems, is usually made more explicit with
descriptions such as “difficulty falling asleep” or
“difficulty staying asleep”;
for example, Insomnia (delayed onset of sleep)
related to overstimulation prior to bedtime
101. Nursing Diagnosis
★ Risk for Injury related to somnambulism
★ Ineffective Coping related to insufficient quality
and quantity of sleep
★ Fatigue related to insufficient sleep
★ Impaired Gas Exchange related to sleep apnea
102. Contd…
★ Deficient Knowledge (non prescription remedies
for sleep) related to misinformation
★ Anxiety related to sleep apnea and/or the
diagnosis of a sleep disorder
★ Activity Intolerance related to sleep deprivation or
excessive daytime sleepiness
103. Planning
The major goal for clients with sleep disturbances is
to maintain (or develop) a sleeping pattern that
provides sufficient energy for daily activities.
Other goals may relate to enhancing the client’s
feeling of well-being or improving the quality and
quantity of the client’s sleep.
104. Contd…
The nurse plans specific nursing interventions to
reach the goal based on the etiology of each nursing
diagnosis.
105. Contd…
These interventions may include
● reducing environmental distractions,
● promoting bedtime rituals,
● providing comfort measures,
● scheduling nursing care to provide for
uninterrupted sleep periods,
● and teaching stress reduction, relaxation
techniques, or good sleep hygiene.
106. Implementing
The term sleep hygiene refers to interventions used
to promote sleep.
Nursing interventions to enhance the quantity and
quality of clients’ sleep involve largely
nonpharmacologic measures.
107. Contd…
These involve health teaching about sleep habits,
support of bedtime rituals, the provision of a restful
environment, specific measures to promote comfort
and relaxation, and appropriate use of hypnotic
medications.
108. Contd…
For hospitalized clients, sleep problems are often
related to the hospital environment or their
illness.
Assisting the client to sleep in such instances can be
challenging to a nurse, often involving scheduling
activities, administering analgesics, and providing a
supportive environment. Explanations and a
supportive relationship are essential for the fearful or
anxious client.
109. Contd…
Different types of hypnotics may be prescribed
depending on the type of sleep problem (e.g.,
difficulties falling asleep or difficulties maintaining
sleep).
Drugs with longer half-lives are often prescribed for
difficulties maintaining sleep, but must be used with
caution in older adults.
111. Contd…
(a) the conditions that promote sleep and those that
interfere with sleep,
(b) safe use of sleep medications,
(c) effects of other prescribed medications on sleep,
(d) effects of their disease states on sleep, and
(e) importance of long periods of uninterrupted sleep
113. Evaluating
If the desired outcomes are not achieved, the nurse
and client should explore the reasons, which may
include answers to the following questions:
● Were etiologic factors correctly identified?
● Has the client’s physical condition or medication
therapy changed?
114. Contd…
● Did the client comply with instructions about
establishing a regular sleep/wake pattern?
● Did the client avoid ingesting caffeine?
● Did the client participate in stimulating daytime
activities to avoid excessive daytime naps?
115. Contd…
● Were all possible measures taken to provide a
restful environment for the client?
● Were the comfort and relaxation measures
effective?
116. Reference
● Berman, Audrey T., Synder, S. and
Frandsen, G. 2016. Kozier and Erb’s
Fundamentals for Nursing: concepts and
practice 10th Edition.USA: Pearson
● Potter , P., Perry, A. Stockert P. and Hall,
A. 2013. Fundamentals of Nursing . 8th
edition. Canada : Mosby Elsevier
Editor's Notes
American Sleep Association: What is sleep? 2017
Kozier and Erb’s Fundamentals for Nursing
Preclude : prevent from happening; make impossible
the NANDA (The North American Nursing Diagnosis Association)