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Test 3 > Chp 33 - Sleep Study Guide > Flashcards

Chp 33 - Sleep Study Guide Flashcards

1
Q

an uncontrollable desire to sleep that can occur at any time

A

narcolepsy

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2
Q

clenching or grinding of teeth from side to side

A

bruxism

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3
Q

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

A

polysomngaphy

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4
Q

bedwetting at night

A

nocturnal enuresis

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5
Q

excessive daytime sleepiness lasting at least 1 month

A

hypersomnia

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6
Q

what physiological and psychological changes occur during sleep

A
  • 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
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7
Q

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

A

REM sleep

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8
Q

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

A

90-120 minutes

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9
Q

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

A

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

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10
Q

Which statements are accurate regarding sleep

A
  • 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
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11
Q

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

A

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

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12
Q

What are two sleep related safety concerns for infants and toddlers

A

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

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13
Q

Behaviors associated with toddlers and preschoolers

A
  • They usually sleep 10-12 hours per night
  • Bedtime rituals are important
  • Nightmares may occur
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14
Q

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

A

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

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15
Q

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

A

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

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16
Q

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

A

Falling asleep while driving or working heavy machinery

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17
Q

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

A

nasal polyps, obesity, alcohol use

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18
Q

What problem scan occur with prolonged sleep apnea

A

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

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19
Q

Sleep deprivation is associated with

A

Nausea, hallucinations, increased sensitivity to pain

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20
Q

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

A
  • 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
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21
Q

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

A

injury to self or others

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22
Q

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

A

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

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23
Q

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

A

NREM1

24
Q

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

A

Haldol

25
Q

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

A

having trouble waking up in the morning

26
Q

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

A

Having one or two classes glasses of wine after dinner

27
Q

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

A

maintain consistency in the same bedtime ritual

28
Q

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

A

What er the child’s usual sleep patterns

29
Q

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

A

have a decline in stage 4 sleep

30
Q

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

A

nocturia

31
Q

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

A

place the infant on its back

32
Q

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

A

what do you do just before going to bed?

33
Q

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

A

excessive snoring

34
Q

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

A

Use the bedroom only for sleep or sexual activity

35
Q

during NREM sleep what happens?

A

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

36
Q

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

A

patterns of biologic and behavioral functions

37
Q

Sleep cycle

A

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

38
Q

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

A

SIDS

39
Q

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.)

A

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

40
Q

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.)

A

nocturnal enuresis, somnambulism, sleep terrors, bruxism

41
Q

underlying cause of secondary sleep disorders

A

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

42
Q

Shift work strategies

A

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

43
Q

sudden loss of voluntary muscle tone

A

cataplexy

44
Q

excessive daytime sleepiness

A

hypersomnia

45
Q

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

A

restless leg syndrome

46
Q

somnambulism

A

sleep walking

47
Q

factors causing sleep alterations

A 
lifestyle
smoking
diet and exercise
alcohol
stimulants and other meds
environmental factors
48
Q

pain due to coronary artery disease is more likely during

A

REM

49
Q

epileptic seizures are more likely during

A

NREM

50
Q

symptoms due to low _______ levels interfere will sleep

A

estrogen

51
Q

end stage renal disease disrupts sleep and leads to

A

daytime sleepiness

52
Q

do medications reset the circadian rhythms?

A

no

53
Q

Activities r/t sleep that can be delegated to UAP

A

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

54
Q

sleep medications

A

antianxiety meds
tricyclic antidepressants
sedative-hypnotics induce sleep

55
Q

Information to be recorded in the sleep diary

A 
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

Test 3 (15 decks)

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