interventions for alterations in rest and sleep

Question 1

rest

Answer 1

a state of mental, physical and spiritual activity that leaves a person feeling refreshed

Question 2

sleep

Answer 2

rest that is accompanied by altered consciousness and relative inactivity

Question 3

what is involved in physiology of sleep

Answer 3

reticular activating system (RAS) and bulbar synchronizing region, hypothalamus (circadian rhythm), neurotransmitters, hormones (melatonin)

Question 4

function of sleep, important for

Answer 4

physiologic, emotional and cognitive function/ body tissue restoration, sorting and discarding of neurotransmitters, character reinforcement

Question 5

stages of sleep

Answer 5

non-rapid eye movement sleep, rapid eye movement sleep

Question 6

non-rapid eye movement sleep

Answer 6

75% of sleep time, PNS is in control. divided into 4 stages (stage 1&2 are light sleep, 3&4 are deep sleep)

Question 7

rapid eye movement sleep

Answer 7

25% of sleep, fluctuation or increase in vital signs, increase in cerebral blood flood and oxygen consumption, relaxation of skeletal muscle, REM rebound

Question 8

non-REM sleep stages, stage 1

Answer 8

transitional state between wakefulness and sleep (hyping jump), lasts only minutes

Question 9

non-REM sleep stages, stage 2

Answer 9

asleep, but a light stage if sleep, easy awakened, makes up about half of all sleep

Question 10

non-REM sleep stages, stage 3

Answer 10

deeper sleep, more difficult to awaken, increased relaxation -> snoring

Question 11

non-REM sleep stages, stage 4

Answer 11

deepest stage, brain activity slows

Question 12

sleep through lifespan: infancy

Answer 12

sleep 16 hrs, sleeps through night at 2-4 months, ABCs of safe sleeping

Question 13

sleep through lifespan: toddlers/ preschool

Answer 13

sleep 11-14 hrs, transition from crib to bed

Question 14

sleep through lifespan: young children

Answer 14

sleep 9-12 hrs, increased need for sleep related to growth spurts

Question 15

sleep through lifespan: adolescents

Answer 15

sleep 8-10 hrs

Question 16

sleep through lifespan: adults

Answer 16

sleep 7-9 hrs, decrease in non-REM stage IV sleep starts in middle age and is absent by older

Question 17

impacts on insufficient sleep

Answer 17

obesity, anxiety, depression, GI complaints, type 2 diabetes, HTN, stroke, substance abuse, motor vehicle accidents

Question 18

insomnia

Answer 18

common in people over 60, acute or chronic, tx: non pharmacologic cognitive behavioral therapy

Question 19

sleep related breathing disorder: obstructive sleep apnea (OSA)

Answer 19

frequent mini arousals during sleep, decreased SWS and REM 10sec-2min apnea episodes (cause HR to increase, BP to increase -> SNS takes over awakens patient)

Question 20

sx of obstructive sleep apnea (OSA)

Answer 20

excessive sleepiness, fatigue, depressed mood, difficulty concentrating, poor memory

Question 21

tx for obstructive sleep apnea (OSA)

Answer 21

CPAP, surgery, weight loss, position changes

Question 22

risks of obstructive sleep apnea (OSA)

Answer 22

linked to CV disease and cognitive impairment

Question 23

central disorders of hyper somnolence

Answer 23

hypersomnia and narcolepsy

Question 24

hypersomnia

Answer 24

excessive (daytime) sleep, naps do not relieve symptoms (awaken disoriented, irritated, slowed thoughts and speech)

Question 25

narcolepsy

Answer 25

excessive daytime sleepiness and frequent overwhelming urges to sleep, most also experience cataplexy (involuntary loss of skeletal muscle tone)

Question 26

circadian rhythm sleep wake disorders

Answer 26

shift work disorder, jet leg

Question 27

shift work disorder

Answer 27

25-33% of shift works experience problems with adequate sleep

Question 28

tx for circadian rhythm sleep wake disorders

Answer 28

CBT (avoid naps, maintaining regular sleep wake tome, avoid stimulation within several hours of bedtime), shifting sleep wake cycle by an hour or 2 over derail weeks is ideal

Question 29

somnambulism

Answer 29

sleep walking

Question 30

REM behavior disorder (RBD)

Answer 30

acting out dreams

Question 31

sleep terrors

Answer 31

occurs in deepest sleep stage (children sit up screaming but not able to reason)

Question 32

nightmares

Answer 32

vivid and disturbing dreams

Question 33

bruxism

Answer 33

teeth grinding

Question 34

enuresis

Answer 34

bed wetting

Question 35

sleep related eating disorder

Answer 35

consumes food but had no recollection

Question 36

sleep related movement disorders

Answer 36

restless legs syndrome (RLS) aka willis ekbom disease (WED)

Question 37

restless legs syndrome (RLS) aka willis ekbom disease (WED)

Answer 37

cannot lie still, unpleasant creeping crawling or tingling sensation/ massage, walking stretching helps/ leads to chronic sleep loss

Question 38

a nurse caring for patients in a busy hospital environment should implement which recommendation to promote sleep

Answer 38

keep the room cool

Question 39

A nurse caring for patients in a long-term care facility is implementing interventions to help promote sleep in older adults. Which action is recommended?

Answer 39

increase physical activities during the day

Question 40

A nurse working in a sleep lab observes the developmental factors that may affect sleep. Which statements accurately describe these variation? Select all that apply

Answer 40

by the age of 8 most children no longer than daily naps, many adolescents do not get enough sleep, Total sleep decreases in adults, with a decrease in stage IV non- REM sleep, sleep is less sound in older adults and stage IV sleep may be absent