Chp 33 - Sleep Study Guide

Question 1

an uncontrollable desire to sleep that can occur at any time

Answer 1

narcolepsy

Question 2

clenching or grinding of teeth from side to side

Answer 2

bruxism

Question 3

the recording of brain waves and other physiological variables, such as muscle activity and eye movements, during sleep

Answer 3

polysomngaphy

Question 4

bedwetting at night

Answer 4

nocturnal enuresis

Question 5

excessive daytime sleepiness lasting at least 1 month

Answer 5

hypersomnia

Question 6

what physiological and psychological changes occur during sleep

Answer 6

• Pulse, respirations, BP, and muscles tone all decrease during sleep
• REM sleep is associated with memory storage, learning, increased cerebral blood flow, and epinephrine release
• Growth hormone is released to repair epithelial and brain cells, cell division for skin and bone marrow renewal occurs, and energy is conserved
• Body temp,, cortisol and melatonin levels change

Question 7

According to normal NREM/REM sequence when does a patient experience dreams and become difficult to arouse

Answer 7

REM sleep

Question 8

What is the recommended amount of uninterrupted time that nurses should provide patients for sleep

Answer 8

90-120 minutes

Question 9

The nurse is working with a patient who is totally blind. How can this affect the individuals sleep patterns?

Answer 9

May not be able to synchronize wake/sleep patterns with sunrise and sunset. His or her circadian rhythm could be disrupted

Question 10

Which statements are accurate regarding sleep

Answer 10

• adults normal fall asleep within 10 minutes
• There are usually three sleep cycles
• Pain can adversely affect the quality of sleep
• Individual who are awakened from sleep will begin their cycle again with the first stage of NREM

Question 11

What physical problems may occur for individuals who sleep less than average

Answer 11

Negative health effects on BP (hypertension), glucose metabolism, and hormone regulation and inflammation, increased frequency of seizures in patients with seizure disorders, and increased weight gain contributing to obesity

Question 12

What are two sleep related safety concerns for infants and toddlers

Answer 12

Infants - place them on their backs to sleep and keeping loose items out of the crib.
Toddler - keeping gates on stairs and locks on doors and cabinets prevents injury from waking during the night

Question 13

Behaviors associated with toddlers and preschoolers

Answer 13

• They usually sleep 10-12 hours per night
• Bedtime rituals are important
• Nightmares may occur

Question 14

What are the causes of dyssomnias (disorders of initiating or maintaining sleep or of excessive sleepiness)

Answer 14

Excessive daytime sleeping, anxiety, depression hight levels of situation at bedtime, medication use, shift work hyperthyroidism

Question 15

The nurse is working with a patient who is experiencing insomnia. What interventions should be included in the teaching plan for this patient

Answer 15

Stimulus control (using the bedroom for only sleep and sex), sleep restriction (staying in bed only when sleeping), sleep hygiene and cognitive therapy (relaxing and changing thought patterns? A combination of non pharmacological methods is often necessary to change sleep patterns. Treatment for hypersomnia is aimed at correcting any underlying conditions contributing to the hypersomnia

Question 16

Identify a potential safety hazard for a patient who is experiencing narcolepsy

Answer 16

Falling asleep while driving or working heavy machinery

Question 17

The nurse is alert to patients who may be predisposed to obstructive sleep apnea, including those individual with which of the following risk factors

Answer 17

nasal polyps, obesity, alcohol use

Question 18

What problem scan occur with prolonged sleep apnea

Answer 18

Increased BP, leading to cardia arrest. Cardia arrhythmias, pulmonary hypertension and left sided hear failure can also result

Question 19

Sleep deprivation is associated with

Answer 19

Nausea, hallucinations, increased sensitivity to pain

Question 20

For the nursing diagnosis of Disturbed Sleep Pattern r/t the schedule and noise in the unit AEB frequent awakenings what nursing interventions should be implemented

Answer 20

• Visual cues to decrease noise by dimming lights and closing curtains but provide a night light for safety.
• Provide privacy by drawing curtains between patients or closing room doors, if possible
• Negotiate times to mute television, radios and music on hospital units
• Limit overhead pages to emergencies only at night
• Lower telephone ringtones
• Limit staff conversations in hallways and at nursing stations
• Conduct shift reports in areas away from patient rooms unless faculty requires it
• Move equipment quietly
• Monitor equipment frequently to prevent alarm tones as much as possible

Question 21

What is the biggest safety factor for someone with somnambulism (sleep walking)

Answer 21

injury to self or others

Question 22

The patient tells the nurse that she has been scheduled for a polysomnography evaluation. What is that

Answer 22

records eye movements, muscle movement, and activity, hear and respiratory rate, oxygen levels, airflow, and brain activity while the patient sleeps. The results of it include the apnea-hypopnea index or the number of apnea or hypopneic episodes per hour. The normal number of these episodes for an adult is fewer that 5/hour. Mild OSA is 5-15/hour. Moderate OSA 15030/hour and Severe OSA more than 30 open or hypopneic episodes/hour

Question 23

The nurse recognizes the stages of sleep and knows that a patient is most easily aroused in which stage

Answer 23

NREM1

Question 24

Which of the following is an antidepressant medication that may be prescribed to promote sleep

Answer 24

Haldol

Question 25

Which of the following is associated with a patient who has hypersomnia

Answer 25

having trouble waking up in the morning

Question 26

The patient has expressed difficulty in sleeping. Upon further investigation by the nurse the patient identifies the following behaviors. Which one should the nurse focus on that may be interfering with the patients sleep

Answer 26

Having one or two classes glasses of wine after dinner

Question 27

The mother of a 2 year old tells the nurse that the child has started crying and resisting going to sleep at the scheduled bedtime. The nurse should advise the parent to

Answer 27

maintain consistency in the same bedtime ritual

Question 28

An 11 year old child in middle school is currently experiencing sleep related father during classes. Which of the following should the nurse ask the parents first

Answer 28

What er the child's usual sleep patterns

Question 29

IN describing the sleep patterns of older adults, the nurse recognized that they

Answer 29

have a decline in stage 4 sleep

Question 30

For a patient who is currently taking a diuretic, the nurse should inform the patient that he or she may experience

Answer 30

nocturia

Question 31

As a result of recent studies regarding SIDS the nurse instruct the parents to

Answer 31

place the infant on its back

Question 32

A 74 year old patient has been heaving sleeping difficulties. In order to have a better idea of the patients problem, the nurse should respond with which of the following

Answer 32

what do you do just before going to bed?

Question 33

Which of the following information provided by the patients bed partner is most associated with sleep apnea

Answer 33

excessive snoring

Question 34

IN teaching methods to promote positive sleep habits at home, the nurse instruct the patient to

Answer 34

Use the bedroom only for sleep or sexual activity

Question 35

during NREM sleep what happens?

Answer 35

growth hormone is released to repair epithelial and brain cells, cell division for skin and bone marrow renewal occurs, and energy is conserved

Question 36

The most familiars rhythm is the day-night-24 hour circadian rhythm cycle. Circadian rhythms influence?

Answer 36

patterns of biologic and behavioral functions

Question 37

Sleep cycle

Answer 37

NREM1, NREM2, NREM3, NREM4, NREM3, NREM2, REM

Question 38

Etiology remains largely unknown, second most common cause of death among infants 1 to 12 months old

Answer 38

SIDS

Question 39

dyssomnias (primary disorders of initiating or maintaining sleep or of excessive sleepiness and are characterized by a disturbance in the amount, quality, or timing of sleep.)

Answer 39

obstructive sleep apnea, shift work sleep disorder, time zone change (jet lag), hypersomnia, restless leg syndrome, narcolepsy, sleep deprivation

Question 40

underlying cause of parasomnias (a category of sleep disorders that involve abnormal movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep.)

Answer 40

nocturnal enuresis, somnambulism, sleep terrors, bruxism

Question 41

underlying cause of secondary sleep disorders

Answer 41

medical conditions, heart failure, COPD, pain, GERD, hospitalization, mental health disorders, depression, fear, anxiety

Question 42

Shift work strategies

Answer 42

6 hours of sleep regular sleep schedule anchor 4 hour sleep time during which sleep is schedule whether on or off of work Dark glasses that block blue light driving home Bright light after waking Power nap 30-90 minutes before shift

Question 43

sudden loss of voluntary muscle tone

Answer 43

cataplexy

Question 44

excessive daytime sleepiness

Answer 44

hypersomnia

Question 45

familial sleep disorder characterized by disagreable leg movements resulting from intense, abnormal lower extremity sensations of crawling or tingling feelings

Answer 45

restless leg syndrome

Question 46

somnambulism

Answer 46

sleep walking

Question 47

factors causing sleep alterations

Answer 47

``` lifestyle smoking diet and exercise alcohol stimulants and other meds environmental factors ```

Question 48

pain due to coronary artery disease is more likely during

Answer 48

REM

Question 49

epileptic seizures are more likely during

Answer 49

NREM

Question 50

symptoms due to low _______ levels interfere will sleep

Answer 50

estrogen

Question 51

end stage renal disease disrupts sleep and leads to

Answer 51

daytime sleepiness

Question 52

do medications reset the circadian rhythms?

Answer 52

no

Question 53

Activities r/t sleep that can be delegated to UAP

Answer 53

Providing oral care Doing a partial bathing of face and hands Providing skin care Giving a back rub Straightening or changing bed linen Offering the opportunity to use the bathroom Offering food or water

Question 54

sleep medications

Answer 54

antianxiety meds tricyclic antidepressants sedative-hypnotics induce sleep

Question 55

Information to be recorded in the sleep diary

Answer 55

``` Activities and food within 2 hours of going to bed Time of retiring Time of awakening Time to fall asleep Number of times aroused during the night Degree of restfulness in the morning Use or non use of an alarm General comments regarding sleep ```