Ch.18 Comfort, Rest, and Sleep

Question 1

____________ is the ability to maintain stable body temperature.

Answer 1

Thermoregulation

Question 2

The rapid eye movement (REM) phase of sleep is referred to as ____________ sleep.

Answer 2

Paradoxical

Question 3

____________ are conditions associated with activities that cause arousal or partial arousal usually during transitions in non-REM (NREM) periods of sleep.

Answer 3

Parasomnias

Question 4

____________ are a class of drugs that excite structures in the brain and cause wakefulness.

Answer 4

Stimulants

Question 5

____________ means difficulty falling asleep, awakening frequently during the night, or awakening early.

Answer 5

Insomnia

Question 6

____________ is a technique used to treat the suppression of melatonin caused by seasonal affective disorder, by stimulating light receptors in the eye.

Answer 6

Phototherapy

Question 7

____________ refers to the waking state characterized by reduced activity and mental stimulation.

Answer 7

Rest

Question 8

The onset of disorientation as the sun sets generally seen in older adults is referred to as ____________ syndrome.

Answer 8

Sundown

Question 9

____________ is a sleep disorder characterized by feeling sleepy despite getting normal sleep.

Answer 9

Hypersomnia

Question 10

Identify the figure

Answer 10

The figure shows characteristic ECG waveforms by sleep stage.

Question 11

Explain the phases of sleep

Answer 11

Sleep is divided into two phases: NREM sleep and REM sleep. These names derive from the periods during sleep when eye movements are either subdued or energetic.

NREM sleep is characterized as quiet sleep
REM sleep is characterized as active sleep

Question 12

Identify the figure

Answer 12

A photosensitive light system influences the sleep–wake cycle.

Question 13

Explain the role of phototherapy in the sleep–wake cycle.

Answer 13

Wakefulness corresponds with sunrise and daylight. Cycles of wakefulness followed by sleep are linked to a photosensitive system involving the eyes and the pineal gland in the brain. Without bright light, the pineal gland secretes melatonin, the hormone that induces drowsiness and sleep. Light triggers suppression of melatonin secretion. Seasonal affective disorder results from excessive melatonin. To counteract these symptoms, phototherapy is prescribed, which suppresses melatonin by stimulating light receptors in the eye.

Question 14

Also known as bed-wetting

Answer 14

Nocturnal enuresis

Question 15

Condition in which the individual walks in their sleep

Answer 15

Somnambulism

Question 16

Condition in which the individual grinds their teeth during sleep

Answer 16

Bruxism

Question 17

Movement, typically in the legs, to relieve disturbing skin sensations

Answer 17

Restless legs syndrome

Question 18

What are the functions of sleep?

Answer 18

Sleep promotes emotional well-being and enhances various physiologic processes.
Sleep is believed to play a role in

• Reducing fatigue
• Stabilizing mood
• Improving blood flow to the brain
• Increasing protein synthesis,
• Maintaining the disease-fighting mechanisms of the immune system
• Promoting cellular growth and repair
• Improving the capacity for learning and memory storage.

Question 19

What is progressive relaxation?

Answer 19

Progressive relaxation is a therapeutic exercise during which a person actively contracts then relaxes muscle groups to break the worry–tension cycle that interferes with relaxation. Clients can learn to perform progressive relaxation exercises independently using self-suggestion. Some clients eventually omit the muscle contraction phase and go directly to the progressive relaxation of muscle groups.

Question 20

What are the factors that affect sleep?

Answer 20

Factors that affect sleep are light, activity, environment, motivation, emotions and moods, food and beverages, illness, and drugs.

Question 21

What is nocturnal polysomnography?

Answer 21

Nocturnal polysomnography is a diagnostic assessment technique in which a client is monitored for an entire night’s sleep to obtain physiologic data. It generally takes place in a sleep disorder clinic, but it is now possible to conduct the study at the client’s home.

A technician monitors a computerized recording system up to 60 feet away.

The diagnostic data are compared with the patterns and characteristics of normal sleep cycles to help diagnose sleep disorders.

Question 22

What is seasonal affective disorder?

Answer 22

Seasonal affective disorder is characterized by hypersomnolence, lack of energy when awake, increased appetite accompanied by cravings for sweets, and weight gain.

The symptoms begin during the darker winter months and disappear as daylight hours increase in the spring.

In some ways, the disorder resembles the hibernation patterns in bears and other animals.

Some suggest that seasonal affective disorder results from excessive melatonin.

Question 23

A client is admitted to the health care facility with a diagnosis of sleep apnea. The nurse understands that the condition can be life-threatening at times.

What are the risks associated with sleep apnea?

Answer 23

During the apneic or hypopneic periods, ventilation decreases and blood oxygenation decreases.

The accumulation of carbon dioxide and the decrease in oxygen cause brief periods of awakening throughout the night.

This disturbs the normal transitions and periods of NREM and REM sleep.

Consequently, clients with sleep apnea/hypopnea syndrome feel tired after having slept, or worse, their symptoms may cause a heart attack, stroke, or sudden death from hypoxia of the heart, brain, and other organs.

Question 24

What nursing interventions should the nurse implement to promote sleep in the client?

Answer 24

The nurse should implement the following interventions to promote sleep in the client:

• Suggest that the client sleep in positions other than the supine position.
• Encourage the client to lose weight.
• Ask the client to avoid substances that depress respiration, such as alcohol and sleeping medication.
• In severe cases, provide the client with a continuous positive airway pressure (CPAP) mask that keeps the alveoli inflated at all times.
• Surgery on the tonsils, uvula, pharynx, tongue, or epiglottis is another treatment option when conservative measures are ineffective.