melatonin - ANSWER supplement (sedative/hypnotic)
-increases REM
-no major S/E
-interacts w/Valerian can increase the effects of other medications
-drowsy, headache, dry mouth (Valerian)
NI: monitor sleep pattern, anxiety level, medical history, avoid alcohol
Melatonin Agonist (Rozerem) - ANSWER sedative/hypnotic
S/E: abnormal thinking, behaviour changes, dizziness, fatigue, hallucination,
nausea
NI: assess sleep pattern before and during therapy, do not give w/high fat meals,
give 30 min prior to bed
Nonbenzodiazepines - ANSWER Sedative/hypnotics
Ambien: stuffy nose, dry mouth, nausea, H/A, fatigue, drowsy, weak
-avoid alcohol, monitor for depression S/S, and report vision changes.
Lunesta: abnormal thinking, behavior change, depression, hallucinations, next
day impairment, peripheral edema, increases latency to REM
-monitor sleep pattern before & during
-assess mental status potential for abuse
-swallow, do not crush pill
Benzodiazepines - ANSWER Sedative/hypnotic
Lorazepam (Ativan)
Temazepam (Restoril)
Triazolam (Halcion)
S/E: dizzy, lethargy, blurred vision, H/A
-risk for insomnia, muscle relaxer, antipsychotics, mildly suppresses REM %,
increases latency REM sleep
NI:check for metabolization of neonates, assess fall risk, avoid grapefruit and
alcohol
Seconal sodium - ANSWER Rarely used, Barbiturate
,S/E: drowsy, H/A, nightmares, dizzy, confusion, nervous, restless, nausea
-decreases REM sleep
NI:decreases hormonal contraceptives, age 65+ should not take, avoid alcohol,
monitor vitals & O2 sat, dependence may develop (taper)
Anhistamine - ANSWER Allergy cold & cough remedy
Diphenhydramine (Benadryl)
S/E: drowsy, H/A, blurred vision, muscle weakness, loss of appetite
-blocks acetylcholine and increases phase of light sleep at the expense of deeper
sleep (REM)
NI:relief of allergic symptoms, mild sedation, prevents motion sickness
Jean Watson's theory of caring - ANSWER Promotes healing and wholeness
Rejects disease orientation to wholeness
Places CARE BEFORE CURE
Emphasizes the nurse-patient relationship
compare and contrast therapeutic communication techniques - ANSWER
Therapeutic:
-Promotes personal growth and attainment of patient's health related goals
-Focuses on the advancement of a patient's emotional and physical well-being
and builds relationships
EX: Active listening (SOLER- sit facing the patient, open position, lean
towards patient, eye contact, and relax), sharing observations, clarifying, using
silence, humor, touch, self-disclosure, sharing empathy, sharing hope, asking
for expanation, cultural awareness, listening fo themes
Non-Therapeutic
-Discourages and damages relationships
-Changing the subject, asking personal questions, sympathy, defensiveness,
arguing, passive/aggressive responses, giving opinions, giving advice, passive
response
Assertive
-Process in which positive and negative ideas are expressed in an open way
-Advocates for the patient and is safe communication
, Therapeutic communication - ANSWER touch, prayer, use of silence, asking
for explanation, cultural awareness, validation, focusing, sharing hope, listening
for themes, empathy, summarizing, confrontation, offering your opinion,
providing info, use of humor, clarify, paraphrase, share feelings, explore/ask
relevant questions
Incorporate features of a helping relationship when interacting with patients -
ANSWER Phases of the Helping/Therapeutic Relationship:
-Pre-interaction phase: occurs before meeting the patient
-Orientation phase: when the nurse and the pt meet and get to know each other
-Working phase: when the nurse and the patient work together to solve
problems and accomplish goals
-Termination phase: occurs at the end of the relationship
Non-judgemental , goal-oriented, one-sided sharing of self different and defined
roles, focus on the needs of one person, helper is leader/facilitator, time-limited
Explain the relationship between knowing a patient and clinical decision
making - ANSWER By knowing the patient, it helps you make clinical
decisions that is patient centered
Explain how an ethic of care influences nurses' decision making - ANSWER
Nurses recognize that the patient is on unequal footing in the healthcare
environment and advocates for the patient
Distinguish between social and therapeutic relationships - ANSWER Social-
relationship of convenience, can choose friend, may be judgemental,
spontaneous, more equal sharing of self/feeling
Therapeutic- relationship between a health provider and patient, patient
centered, timed, patient's needs are met
Demonstrate qualities, behaviors and communication techniques of professional
communication while interacting with patients. - ANSWER Children:
-Ask open ended questions, use multiple methods to present information, people
first language, encourage child to be an active participant
-People first language- don't label the person for what disease they have. EX:
Instead of: saying 'mental retardation', say: the child with cognitive disabilities