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Behavioral Health > Chapter 19 > Flashcards

Chapter 19 Flashcards

0
Q

The subjective report of difficulty staying awake. Serious enough to impact social and vocational functioning.

A

Excessive sleepiness

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1
Q

The major consequence of acute or chronic sleep curtailment is…

A

Excessive sleepiness

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2
Q

Excessive sleepiness can increase the risk for ______ and _______

A

Accident, injury

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3
Q

A discrepancy between hours of sleep obtained and hours of sleep required for optimal functioning causes a state of

A

Sleep deprivation

*Applies only to impaired functioning due to sleep loss

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4
Q

Getting ______________ hours of sleep at night is associated with:
Impaired glucose tolerance
Elevated cortisol levels
Alterations in sympathetic nervous system activity
Increase risk of cardiovascular disease and diabetes.

A

Less than 6 hours

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5
Q

Daytime wakefulness in excess of ___________ hours can produce psychomotor deficits equivalent to BACs of 0.05-0.1%

A

17-19

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6
Q

A dynamic neurological process that involves complex interaction between the central nervous system and the environment.

A

Sleep

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7
Q

The time it takes to fall asleep

A

Sleep latency

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8
Q

During this stage of sleep, body temperature declines, muscles relax, and eyes slowly roll. Awareness is lost but the person is easily aroused.

A

NREM1

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9
Q

During this stage of sleep, the heart rate and respiratory rate decline.

A

NREM2

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10
Q

This stage of sleep is known as slow wave sleep or delta sleep. It is a short phase and heart rate, respiratory rate, and blood pressure decreases. Response to external stimuli is limited

A

NREM3

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11
Q

This stage is considered to be “restorative sleep” and sympathetic activity is reduced.

A

NREM3

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12
Q

This stage of sleep is characterized by reduction and absence of skeletal muscle tone (muscle atonia), bursts of rapid eye movement, myoclonic twitches of the face and limbs, and autonomic nervous system variability. Dreaming is reported during this stage.

A

REM

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13
Q

There are typically _______ cycles of NREM/REM during the sleep period.

A

4-6

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14
Q

The structural organization of NREM and REM sleep often displayed graphically as a hypnogram.

A

Sleep architecture

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15
Q

The distribution of sleep and wakefulness across the sleep period.

A

Sleep continuity

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16
Q

What medication suppresses slow wave sleep and what medication suppresses REM sleep?

A

Benzodiazepines, serotonergic

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17
Q

The homeostatic process that promotes sleep

A

Sleep drive

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18
Q

The homeostatic process that promotes wakefulness

A

Circadian drive

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19
Q

Patients who take _______ frequently report difficulty sleeping.

A

SSRIs

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20
Q

Long sleepers need _______ hours of sleep per night while short sleepers need _____ hours of sleep per night. The amount of sleep necessary to feel fully awake and able to sustain normal levels of performance during the periods of wakefulness is known as ________.

A

Over 10hours, Less than 6 hours, Basal sleep requirements

21
Q

What is the most accurate way to determine sleep requirements?

A

Allow oneself to sleep undisturbed without an alarm for several days. The average of several nights’ undisturbed sleep is a good estimate of basal sleep requirement

22
Q

The most common sleep test used to diagnose and evaluate patients with sleep-related breathing disorders and nocturnal seizure disorders.

A

Polysomnography

23
Q

A daytime nap test used to objectively measure sleepiness in a sleep-conductive setting.

A

MSLT

24
Q

Used to document adequate alertness in individuals with careers for which sleepiness would pose a risk to public safety.

A

MWT

25
Q

Uses a wristwatch-type device to record body movements. Used in patients with circadian rhythm disorders and insomnia.

A

Actigraphy

26
Q

These sleep disorders are associated with excessive daytime sleepiness. They are chronic disorders.

A

Hypersomnolence disorders

27
Q

Clinical manifestations of Hypersomnolence disorders:

A
  • Recurrent periods of sleep
  • Unintended lapses into sleep
  • Frequent napping
  • Prolonged main sleep period (greater than 9 hours)
  • Non-refreshing, non-restorative sleep regardless of amount slept
  • Difficulty with full alertness during wake period
28
Q

Symptoms of this sleep disorder include attacks of refreshing sleep, cataplexy, hypnagogic hallucinations, and sleep paralysis.

A

Narcolepsy

29
Q

Characterized as repeated episodes of upper airway collapse and obstruction that result in sleep fragmentation.

A

OSA

30
Q

Symptoms of OSA

A
  • Loud, disruptive snoring
  • Excessive daytime sleepiness
  • Apnea episodes
31
Q

Treatment for OSA

A

CPAP

32
Q

Occur when there is misalignment between the timing of the individual’s normal circadian rhythm and external factors that affect the timing or duration of sleep.

A

Circadian rhythm sleep disorders

33
Q

Characterized by long, frightening dreams from which people awaken scared.

A

Nightmare disorders

34
Q

Characterized by absence of muscle atonia during sleep. patients display elaborate motor activity associated with dream mentation (acting out dreams)

A

REM sleep behavior disorder

35
Q

Sensory and movement disorder characterized by an unpleasant, uncomfortable sensation in the legs accompanied by urge to move.

A

RLS (restless leg syndrome)

36
Q

Sleep disorder characterized by difficulty with sleep initiation, sleep maintenance, early awakening with difficulty returning to sleep, or nonrefreshing nonrestorative sleep.

A

Insomnia disorder

37
Q

Insomnia disorder symptoms must be present at least ___ times per week for a period of at least ____ months despite ___________ to be diagnosed.

A

3, 3, adequate sleep

38
Q

Sleeping less than ____ hours per night may have significant impact on cardiovascular, endocrine, immune, and neurological function.

A

6

39
Q

OSA is associated with…

A

Hypertension
Diabetes
Cardiovascular disease
Stroke

40
Q

Many patients complain of ______, __________, _______, or __________ instead of directly complaining of sleep disturbance.

A

Fatigue
Decreased concentration
Mood disturbance
Physical ailments

41
Q

In order to help assess the patient, the nurse may assign….

A

patient to complete a 2 week sleep diary.

42
Q

Assessment tools for sleep disturbances are the ________________ and ___________ and scores that determine issues in sleep are…

A
  • -Pittsburgh Sleep Quality Index (sum of 5+ indicates poor quality/patterns of sleep)
  • -Epsworth Sleepiness Scale (Scores of less than 10=normal, 10-15= moderately sleepy, 15+=excessively sleepy)
43
Q

Nursing diagnosis for sleep disturbance include… (4)

A

Insomnia
Sleep deprivation
Disturbed sleep pattern
Readiness for enhanced sleep

44
Q

Nursing diagnosis that relates to a disruption in amount and quality of sleep that impairs function

A

Insomnia

45
Q

Nursing diagnosis described by prolonged periods of time without sleep

A

Sleep deprivation

46
Q

Nursing diagnosis described by changes in sleep routines that cause impairment in social or vocational functioning

A

Disturbed sleep pattern

47
Q

Nursing diagnosis characterized by a pattern of natural, periodic suspension of consciousness that provides adequate rest, sustains a desired lifestyle, and can be strengthened

A

Readiness for enhanced sleep

48
Q

Overall sleep efficiency is calculated by…

A

Time in bed divided by total sleep time x 100

49
Q

Limiting the total sleep time to create a temporary, mild state of sleep deprivation and strengthen the sleep homeostatic drive. Helps to decrease sleep latency and improve sleep continuity and quality.

A

Sleep restriction (should not be reduced to below 5 hours)

50
Q

The five basic principles of stimulus control are:

A
  • Go to bed only when sleepy
  • Use bedroom only for sleep/intimacy
  • Get out of bed if unable to sleep and do a quite activity
  • Maintain regular sleep/wake schedule
  • Avoid daytime napping

Behavioral Health (6 decks)

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