N1B Sleep Flashcards
1
Q
controlled within the body and synchronized with environmental factors
A
biological rhythms
2
Q
records brain waves
A
EEG
3
Q
records muscle activity
A
EMG
4
Q
records eye movement
A
EOG
5
Q
individual obtains sufficient sleep at night but has difficulty staying awake during the day
A
HYPERSOMNIA
6
Q
inability to fall asleep or remain asleep
A
INSOMNIA
7
Q
excessive daytime sleepiness caused by lack of chemical in area of the CNS that regulates sleep
A
NARCOLEPSY
8
Q
orgasm and release of semen during sleep
A
NOCTURNAL EMISSIONS
9
Q
Four stages; essential for physiological well-being
A
NREM SLEEP
10
Q
behavior that may interfere with sleep, and may occur during sleep
A
PARASOMNIA
11
Q
use of several monitoring and recording devices used to measure objectivity
A
POLYSOMOGRAPHY
12
Q
occurs about every 90 minutes; essential for psychosocial and mental equilibrium
A
REM SLEEP
13
Q
naturally occurring aLOC in which perceptions and reactions are decreased
A
SLEEP
14
Q
characterized by frequent, short breathing pauses during sleep
A
SLEEP APNEA
15
Q
basic organization of normal sleep
A
SLEEP ARCHITECTURE
16
Q
interventions used to promote and enhance the quality of client’s sleep
A
SLEEP HYGIENE
17
Q
Somnology is the study of sleep.
True
False
A
true
18
Q
Stage 1 is the deepest stage of sleep.
True
False
A
false
stage 3 is the deepest stage of sleep
19
Q
Most dreams take place during REM sleep, but usually will not be remembered unless the individual arouses at the end of the REM period..
True
False
A
true
20
Q
Sleep apnea is characterized by frequent short breathing pauses during sleep.
True
False
A
true
21
Q
Sleep hypnotics is a term referring to interventions used to promote sleep.
True
False
A
true
22
Q
REM sleep usually occurs about every________minutes and lasts 5 to 30 minutes
A
90
23
Q
_____ is a disorder of excessive daytime sleepiness caused by lack of the chemical hypocretin in the area of the central nervous system that regulates sleep
A
narcolepsy
24
Q
a pattern of symptoms (agitation, anxious, aggressive, and sometimes delusional) that occur in the late afternoon
A
sundown syndrome
25
the most common sleep complaint in America
insomnia
26
learning to develop positive thoughts and beliefs about sleep
cognitive therapy
27
a subjective characteristic often determined by whether or not a person wakes up feeling energetic or not
sleep quality
28
the study of sleep
somnology
29
conditions where the affected individual obtains sufficient sleep at night but still cannot stay awake during the day
hypersomnia
30
the total time the individual sleeps
quantity of sleep
31
creating a sleep environment that promotes sleep
stimulus control
32
the basic organization of normal sleep
sleep architecture
33
Newborns sleep hours a day, on an irregular schedule with periods of 1 to 3 hours spent awake.
a. 10 to 12
b. 12 to 14
c. 14 to 16
d. 12 to 18
d
34
Most healthy adults need hours of sleep a night.
a. 7 to 9
b. 9 to 11
c. 11 to 13
d. 13 to 15
a
35
Stress is considered by most sleep experts to be the number cause of short-term sleeping difficulties.
a. one
b. two
0. three
a
36
By the end of the first year, how many hours of sleep should an infant receive during the day?
a. 7to8
b. 9to l2
c. 12tol3
d. 14to 15
b
37
Approximately___ million Americans have a chronic disorder of sleep and wakefulness that hinders daily functioning and adversely affects health
30-50
38
About 75% to 80% of sleep during a night is
NREM
39
NREM STAGE 1
very light sleep and lasts only a few minutes
individual is drowsy and relaxed
eyes roll from side to side, heart and RR drop slightly
can be readily awakened
40
NREM STAGE 2
light sleep during which body processes continue to slow down
eyes are generally still, the heart and RR decrease slightly, body temp falls
lasts 10-15 min
constitutes 44% to 55% of total sleep
41
STAGE 3 AND 4
the deepest stages of sleep
deep or delta sleep
HR and RR drop 20% to 30% below those exhibiting waking hours
difficult to arouse, not disturbed by sensory stimuli
skeletal muscles relaxed, reflexes diminished, snoring is most likely to occur
saliva production decreased
important for restoring energy and releasing important growth hormones
42
REM sleep
- peripheral blood vessels dilate
- arterial BP falls
- pulse rate decreases
- cardiac output decreases
usually recurs about every 90 minutes and lasts 5 to 30 minutes. Most dreams take place during REM sleep, but usually won't be remembered unless individual arouses briefly at the end of the REM period. During REM sleep, the brain is highly active, and brain metabolism may increase as much as 20%. EEG resembles that of wakefulness. Ach and dopamine released. Distinctive eye movement occurs, voluntary muscle tone is dramatically decreased and DTR are absent. Individual may be difficult to arouse or may awake spontaneously, gastric secretions increase. HR and RR are irregular. Regions of the brain that are used in learning, thinking, and organizing information are stimulated.
43
During discharge planning, the nurse is teaching the client how to maintain a sleep diary. Which of the following statements is correct?
1. Document the activities you perform 5 to 6 hours before going to bed.
2. Document the consumption of caffeinated beverages and alcohol and amounts of those beverages.
3. Do not list the bedtime rituals before bed.
4. List only the prescribed medications taken during the day.
2
44
A nurse is evaluating a client’s understanding of comfort measures that are essential to help fall asleep
and stay asleep. Which of the following client statements indicates a need for further teaching?
1. “I should wear loose-fitting nightwear.”
2. “I will void before bedtime.”
3. “I will perform hygienic routines prior to bedtime.”
4. 4. “When I’m in pain, l will take the prescribed analgesics 1 hour before I go to sleep.”
4
45
A nurse is evaluating a nursing student’s understanding of medications. Which of the following statements by the nursing student indicates a need for further teaching?
1. “Antianxiety medications decrease levels of arousal by facilitating the action of neurons in the CNS that
suppress responsiveness to stimulation.”
2. “Sleep medications vary in their onset and duration of action and will impair waking function as long as
they are chemically active.”
3. “Sleep medications affect NREM sleep more than REM sleep.”
4. “Initial doses of medications should be low and increases added gradually, depending on the client’s response.”
3
46
Hypersomnia is:
1. A condition in which the affected individual obtains sufficient sleep at night but still cannot stay awake
during the day.
2. A disorder of excessive daytime sleepiness caused by the lack of the chemical hypocretin in the area of the
central nervous system that regulates sleep.
3. A condition characterized by frequent short breathing pauses during sleep.
4. A behavior that may interfere with sleep and/or occurs during sleep.
1
47
Which stage of NREM (slow-wave) sleep lasts only about 10 to 15 minutes, during which the eyes are generally still, the heart and respiratory rates decrease slightly, and body temperature falls?
1. Stage l
2. Stage 2
3. Stage 3
4. Stage 4
2
48
A nurse is evaluating a nursing student who is discussing physiological changes during NREM sleep. Which of the following statements by the nursing student demonstrates a need for further teaching?
1. Arterial blood pressure falls.
2. Pulse rate decreases.
3. Peripheral blood vessels constrict,
4. Cardiac output decreases.
3
49
When planning interventions to reduce environmental distractions in hospitals, which of the following would
NOT be included in the client’s plan of care?
1. Lower the ring tone of nearby telephones.
2. Discontinue use of the paging system after a certain hour or reduce its volume.
3. Keep required staff conversations at low levels; conduct nursing reports or other discussions in a separate
area away from client rooms.
4. Perform noisy activities only during the day, never during sleeping hours.
4
50
A nurse is planning a seminar on promoting sleep. Which of the following is correct information?
1. Establish a regular bedtime and wake-up time for all days of the week to enhance biologic rhythm.
2. Complete office work or discuss family problems before bedtime.
3. Get adequate exercise during the day to reduce stress, but avoid excessive physical exertion 1 hour before bedtime.
4. Establish a regular, relaxing bedtime routine before sleep such as exercising or taking a cool shower.
1
3 should be at least 3 hours
51
When planning interventions to promote sleep, which of the following would be included in the client’s plan
of care?
1. Create a sleep-conducive environment that is dark, quiet, comfortable, and cool.
2. Give analgesics 3 hours before bedtime to relieve aches and pains.
3. If a bedtime snack is necessary, give only high-carbohydrate snacks or a milk drink.
4. Avoid giving the client heavy meals 4 to 5 hours before bedtime
1
4 is 2 to 3 hours
52
A nurse is evaluating a client’s understanding of her child’s night terrors. Which of the following statements
indicates a need for further teaching?
1. Night terrors are usually seen in children 3 to 6 years of age.
2. Children usually cannot be wakened during night terrors, but should be protected from injury, helped back
to bed, and soothed back to sleep.
3. Children do not remember the night terror the next day, and there is no indication of a neurologic or emotional problem.
4. Night terrors are partial awakenings from non-REM stage 3 or 4 sleep
4
53
Types of sleep
NREM (non-rapid eye movement)
REM (Rapid eye movement)
*These two types of sleep alternate in cycles
*Whole cycle lasts about 90-110 minutes
*Most people experience 4-6 cycles in an 8 hour sleep period
-Stage 1-2 = 20-30 mins
-Stage 3 = 50-60 mins
-Stage 2-1 = 20 mins
-1st REM =10 mins
*Any sleep who is awakened must start again at stage 1
54
NREM sleep
Occurs when activity in the RAS (reticular activating system) is inhibited.
70%-80% of sleep is NREM
Divided into 3 stages:
Stage One- Very light sleep, last only a few minutes, sleeper can be readily awakened
Stage Two- Body processes continue to slow down. HR + RR decrease slightly. Requires more stimulus to wake (e.g. touching or shaking)
Stage Three- Deepest stage of sleep (delta sleep), big drop in sleeper’s HR + RR, difficult to arouse, essential stage for restoring energy and releasing important growth hormones.
55
REM sleep
Usually recurs every 90 minutes and lasts 5-30 minutes.
When dreaming occurs (won’t be remembered unless person is awakened right at the end of a REM cycle)
Brain is highly active (EEG resembles wakefulness)
Eye movement occurs, decreased voluntary muscle tone, decreased deep tendon reflexes.
56
Bruxism
teeth grinding
57
Enuresis
bed wetting
58
sleep hygiene practices
(1) Identify personal activity and sleep
patterns.
(2) Engage participation in activity and
exercise during the day to reduce stress and
deplete energy.
(3) Avoid daytime naps unless they are less
than 30-minute naps (power naps) to
prevent insomnia at night.
(4) Avoid physical exertion for 1 to 2 hours
before bedtime to limit stimulation before
attempting sleep.
(5) Avoid heavy and spicy meals for 2 to 3 hours
before bedtime to reduce the risk of gastrointestinal (GI) distress and esophageal
reflux.
(6) Avoid nicotine and caffeine-containing foods
and beverages, such as coffee, tea, colas, and
chocolate, for 4 hours before bedtime to limit
the stimulating effects of these products
(half-life of nicotine is 1 to 2 hours).
(7) Avoid alcohol for 4 hours before bedtime to
limit the need to void during the night because of alcohol’s diuretic effect and to limit
early awakening.
(8) Consume products containing sleep promoting constituents: Small snack of
carbohydrates and protein, such as cheese
and crackers; carbohydrates limit the sensation of hunger while protein reduces the
sugar boost of the carbohydrate.
(9) Establish a daily bedtime routine, such as
reading, taking a warm bath, listening to
music, performing specific hygiene practices, and choosing a consistent time to go
to bed and arise.
(10) Control the environment, such as by turning off lights, limiting environmental noise,
setting a preferred environmental temperature, and using “white noise,” such as
sounds of rain drops or wind, to limit
stimuli that may delay or interrupt sleep.
(11) Perform relaxation techniques, such as
imagery, diaphragmatic breathing, and
progressive muscle relaxation, to reduce
muscle tension and promote relaxation.
(12) Get out of bed if not asleep within
30 minutes and return to bed when
sleepy to establish an expectation that
sleep should follow when in bed; use the
bed only for sleeping and sexual activity.
(13) Avoid consistent use of medication for sleep
to prevent physical or emotional dependence
