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Fundamentals 2 > Chapter 12: Sleep and Rest > Flashcards

Chapter 12: Sleep and Rest Flashcards

1
Q

Condition characterized by at least five leg jerks or movements per hour during sleep

A

Nocturnal Myoclonus

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2
Q

Falling asleep earlier in the evening and awakening earlier in the morning

A

phase advance

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3
Q

Neurological disorder characterized by an uncontrollable urge to move the legs when one

A

restless legs syndrome

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4
Q

Delay in the onset of sleep

A

sleep latency

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5
Q

A person spends __ of his/her lifetime sleeping.

A

1/3

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6
Q

__, ___, and ___ are all highly prevalent among the older adults. (tired)

A

Insomnia, daytime sleepiness, and napping

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7
Q

In most cases, insomnia, daytime sleepiness, and napping result from age-related changes in :

A

circadian sleep–wake cycles
sleep architecture (stages)
sleep efficiency
sleep quality

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8
Q

Reductions in non–rapid eye movement stage sleep and rapid eye movement (REM) stage sleep begin to occur after __.

A

midlife

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9
Q

Older or younger adults spend more time in stages I and II sleep?

A

Older

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10
Q

Older or younger adults have a decline in the proportion of time spent in the deeper stages III and IV sleep?

A

Older

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11
Q

What Stage?
Begins nodding off
Can be easily awakened
If undisturbed, will reach next stage in a few minutes

A

Stage 1

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12
Q

Deeper stage of relaxation reached
Some eye movement noted through closed lids
Can be easily awakened

A

Stage 2

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13
Q

Early phase of deep sleep
Reduced temperature and heart rate
Muscles relaxed
More difficult to be awakened

A

Stage 3

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14
Q

Deep sleep and relaxation
All body functions reduced
Considerable stimulation needed to be awakened
Insufficient stage IV sleep can cause emotional dysfunction

A

Stage 4

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15
Q

-Increased vital signs (sometimes irregular)

Decreased due to reduced amount of sleep time in general

A

REM

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16
Q

Insufficient REM sleep can cause ___

A

emotional dysfunction, including psychosis

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17
Q

People will enter REM sleep approximately once every __ minutes of stage __ sleep.

A

90 min

IV

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18
Q

The nurse can assess for sleep disturbances in the older adult by using a self-rating tool such as the ___.

A

Pittsburgh Sleep Quality Index

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19
Q

Research has shown that ___ is a better predictor of suicide in older adults than depressive symptoms.

A

poor sleep quality

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20
Q

In addition, shorter sleep duration and restless sleep have been found to be associated with higher levels of beta amyloid in the brain, which is a biomarker for ___

A

Alzheimer’s disease

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21
Q

Insomnia can be a short-term, which is also known as ___.

A

transient

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22
Q

A changed environment, illness, added stress, or anxiety is associated with with problem?

A

Transient insomnia

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23
Q

Chronic insomnia is:

A

insomnia lasting 3 or more weeks

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24
Q

Physical or mental illnesses, environmental factors, substance abuse, or medications can be related to __ __.

A

Chronic insomnia

25
Q

Nocturnal Myoclonus is associated with:

A

the use of tricyclic antidepressants and chronic renal failure.

26
Q

People with restless legs syndrome may describe the sensations with terms such as:

A 
uncomfortable
electrical
itching
pins and needles
pulling
creepy-crawly
painful
27
Q
  • This condition can be caused by iron deficiency anemia, uremia, Parkinson’s disease, rheumatoid arthritis, diabetes, or neurological lesions
  • it is believed to be associated with alterations in dopamine and iron metabolism.
  • Antidepressants, antihistamines, antipsychotics, alcohol, caffeine, hypoglycemia, and simple and refined carbohydrates can contribute to this syndrome.
  • Dehydration worsens symptoms
A

Restless legs syndrome

28
Q

This condition is characterized by snoring and sudden awakening and gasping for air

A

sleep apnea

29
Q

The prevalence of sleep apnea is __x more prevalent in men than women.

A

3

30
Q

This disorder can be caused by a defect in the central nervous system that affects the diaphragm, a blockage in the upper airway that interferes with normal air flow, or a combination of both.

A

Sleep apnea

31
Q

3 types of sleep apnea:

A
  • central sleep apnea: a defect in the central nervous system that affects the diaphragm
  • obstructive: a blockage in the upper airway that interferes with normal air flow
  • mixed: combo of both
32
Q

Sleep apnea: Sleeping in a supine position should be avoided because it __-

A

allows the tongue to fall back and block the airway.

33
Q

People with dementia have minimal stage__ and __ sleep, no stage __ sleep, and frequent arousals from sleep.

A

II and REM

IV

34
Q

A sudden change to earlier awakening or insomnia may be symptomatic of an emotional disturbance or __

A

alcohol abuse

35
Q

Examples of drugs that can interrupt sleep include:

A 
anticholinergics
antidepressants
antihypertensives (centrally acting ones), benzodiazepines
β-blockers
diuretics
levodopa
steroids
theophylline
thyroid preparations
36
Q

___ interfere with REM and deep sleep stages and can cause daytime drowsiness (due to their extended half-lives in older people), thereby creating difficulties in falling asleep for the patient

A

Hypnotics

37
Q

Many of the top nonprescription sleep aids contain ___ as a primary ingredient

A

diphenhydramine (Benadryl)

38
Q

5 drugs that can affect sleep include:

BE Xtra NICe PROposed THEO

A
  • diphenhydramine (Benadryl)
  • nicotine
  • alprazolam (Xanax)
  • fluoxetine HCl (Prozac)
  • theophylline (Theo-X Extended-Release tabs)
39
Q

Benadryl carries a high risk of ____ and it should be avoided.

A

anticholinergic side effects in older adults

40
Q

Every assessment needs to include a sleep history, which includes:

A
  • Review of time spent in sleep and naps, quality of sleep
  • Medication review
  • Bedtime routines
  • Presence of sleep disturbances (if present)
41
Q

If sleep disturbances are present, what are the characteristics involved?

A
  • Length of time present
  • Characteristics (e.g., falling asleep, staying asleep, and early awakening)
  • Type of bedding and sleep environment
  • Food and fluid consumed several hours prior to bedtime
  • Medications used to address sleep disturbances
  • Factors interfering with sleep (e.g., pain, voiding, and nightmares)
  • Effects (e.g., daytime drowsiness, irritability, and fatigue)
  • Management
42
Q

___ are general depressants, especially to the central nervous system, and they can significantly depress some vital body functions, lowering basal metabolic rate more than it already is and decreasing blood pressure, mental activity, and peristalsis to the extent that other problems may develop.

A

Barbiturates

43
Q

T/F: Exposure to sunlight during the day can facilitate sleep at night

A

True

44
Q

Foods high in carbohydrates tend to raise the level of __ in the brain, which could have a sedating effect.

A

serotonin

45
Q

T/F: A protein and carbohydrate snack at bedtime may encourage sleep.

A

True

46
Q

The supplement melatonin (a synthetic form of the hormone that is naturally stimulated by darkness) has gained popularity for improving the quality of sleep in adults of all ages by ___

A

correcting imbalances in the body’s circadian rhythm.

47
Q

Are demands and activity levels correlated with stress?

A

Not necessarily

48
Q

Regardless of the source of the stress, the body reacts by stimulating the ___

A

Sympathetic nervous system.

49
Q

The Sympathetic nervous system causes:

A
  • stimulation of the pituitary gland
  • the release of adrenocorticotropic hormone
  • an increase in the body’s adrenaline supply.
50
Q

4 measures to control stress:

A
  • respond to stress in a healthy manner
  • manage lifestyle
  • relax
  • pray
51
Q

___ of pain is the essential first step to controlling it.

A

Identifying the cause

52
Q

If nonpharmacologic means of pain relief are ineffective and drugs are necessary, it is advisable to begin with ___

A

the weakest type and dosage of analgesic and gradually increase as necessary.

53
Q

Older adults tend to fall asleep and wake up ___.

A

earlier than in younger years

54
Q

Older adults sleep more/less soundly?

A

less

55
Q

Older adults have a reduction in stage __ sleep.

A

IV

56
Q

__, __, __, and __ are among the most common disturbances to the sleep of older adults.

A

Insomnia, nocturnal myoclonus, restless legs syndrome, and sleep apnea

57
Q

The variety of factors that can affect sleep requires that a ___ be done as part of the comprehensive assessment.

A

thorough sleep history

58
Q

A variety of measures can be used to promote sleep, including:

A
  • adjustment to activities and nap times
  • limitation of caffeine consumption
  • soft music
  • back rubs
  • decaffeinated herbal teas
  • stress management
  • control of noise and lighting.
59
Q

Restless legs syndrome is believed to be associated with alterations in __ and ___

A

dopamine and iron metabolism.

Fundamentals 2 (16 decks)

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