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Nursing 171 > NURS 171: Week 12: Sleep and Rest > Flashcards

NURS 171: Week 12: Sleep and Rest Flashcards

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1
Q

Rest

A
  • inactive with mild to no activity
  • relaxation; stress-free
  • leads to feeling refreshed
    ex: reading, listening to music, surfing the internet, praying or meditating, gardening, playing golf
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2
Q

Sleep

A
  • cyclical states/ altered consciousness
  • decreased motor activity/ perception
  • selective response to external stimuli
  • metabolism decreases
    ex: unaware of environment and responds selectively to external stimuli (alarm clock, bright light)
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3
Q

Why Do We Need Sleep?

A

-essential for physical, mental, and spiritual well being
-sleep, rest, and illness are interrelated
-increases mental performance
>improves learning
>helps the storage of long-term memory
-restores energy
-improves ability to cope
-strengthens immune system

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4
Q

How Much Sleep Do We Need?

A
  • older adults: need less (5-7 hrs) plus naps
  • newborns: 16-20
  • adolescents: 8-9
  • young adults: 7-8
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5
Q

Circadian Rhythm

A
  • internal clock affected by light
  • 24-hour-day-night sleep/wake pattern
  • affects overall level of functioning
  • people who work evening and night can suffer significant sleep deprivation until body adjusts to shift
  • changing time zones and hospitalization can lead to disrupted sleep wake cycles
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6
Q

How is Sleep Regulated?

A

-reticular activating system (nerve pathways affecting consciousness)
-stages of sleep
-cycles average of 90 to 120 minutes
>NREM (restful place)
>REM (brain highly active)

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7
Q

What Factors Affect Sleep?

A
  • total amount of sleep
  • how well the person slept
  • whether the needed amounts of NREM and REM were achieved
  • sleep amounts and sleep patterns vary
  • seep quality has both subjective and objective components
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8
Q

Factors Affecting Sleep In Older Adults

A
  • nocturia
  • side effects of medications
  • discomfort or pain
  • partners sleep habits (snoring, restlessness)
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9
Q

Factors Affecting Sleep In Young Adults

A
  • studying all night
  • driven to succeed
  • late work nights
  • stress
  • parents of young children with sleep disturbances
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10
Q

Factors Affecting Sleep

A
  • Lifestyle Factors
  • Illness
  • Environmental Factors
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11
Q

Factors Affecting Sleep: Lifestyle Factors

A

-Physical Activity: exercise more than 2 hours before bedtime
-Food: can promote or interfere with sleep
>saturated fat, L tryptophan, carbohydrates
-Alcohol: go to sleep easier but disrupts REM sleep
-Medications: promotes or interrupts sleep
-Nicotine + Caffeine: stimulants

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12
Q

Saturated Fat Vs Effects on Sleep

A

interferes with sleep

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13
Q

L. tryptophan vs Sleep

A

(milk + cheese)

-may induce sleep

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14
Q

Carbohydrates Vs Sleep

A

seem to promote relaxation

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15
Q

Factors Affecting Sleep: Illness

A
  • increases need for sleep + rest

- associated with mental + physical distress that disturb sleep

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16
Q

Factors Affecting Sleep: Environmental Factors

A

promote or inhibit sleep

  • temperature + humidity
  • noise + light
  • odors or allergies
  • comfort of bedding
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17
Q

Common Sleep Disorders

A

-Insomnia
-Circadian Disorders
-Restless Leg Syndrome
Dyssomnias:
>hypersomnia
>sleep apnea
Parasomnias:
>sleepwalking, sleep-talking, bruxism, night terrors, REM sleep behavior disturbances, Enuresis (bedwetting)

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18
Q

Insomnia

A

inability to fall or remain asleep or go back to sleep

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19
Q

Insomnia Treatment

A

a combination of behavioral and pharmacological therapy may be effective
-some sleep aids are habit forming

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20
Q

Circadian Disorders

A

abnormality in sleep/wake times

e.g. jet lag, working night shift, rotating shifts

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21
Q

S + S of Circadian Disorders

A
  • decreased ability to perform psycho-motor tasks

- short sleep episodes person is not aware of (dozing off)

22
Q

Treatment of Circadian Disorders

A

need several days to adjust sleep wake schedule

23
Q

Restless Leg Syndrome

A

disorder of the CNS with overwhelming urge to move the legs while resting or before sleep onset

24
Q

S + S of Restless Leg Syndrome

A

-unpleasant creeping, crawling, itching, or tingling sensation in the legs

25
Q

Treatment for Restless Leg Syndrome

A
  • relieved only by moving the legs
  • may include neuroleptic agents and medication used to treat parkinsons disease
  • avoid caffeine + other stimulants
  • walking
  • massage
  • stretching
  • heat or cold compresses
  • medication vibration
  • acupressure
26
Q

Dyssomnias

A

trouble falling or staying asleep

  • hypersomnia
  • sleep apnea
27
Q

Dyssomnia: Hypersomnia

A

excessive sleeping (especially during daytime)

  • sleep-related or disease-related
  • can be related to depression
  • can be related to sleep apnea or narcolepsy or disorders of CNS, kidney, liver or metabolic disorders (diabetic acidosis and hypothyroidism)
28
Q

Dyssomnia: Sleep Apnea

A
  • snoring is the biggest sign of obstructive sleep apnea
  • soft tissue of pharynx and soft palate collapse + obstruct airway for at least 10 seconds during sleep cycles
  • oxygen level in blood drops and carbon dioxide level rises causing person to wake up
  • complain of fatigue and morning headache
  • diagnosed with sleep study
29
Q

Narcolepsy

A

genetic defect of the CNS in which REM sleep can not be controlled

  • chronic disorder caused by the brains ineffectiveness in regulating sleep-wake cycles normally
  • sudden, uncontrollable episodes of sleep during the day
30
Q

S + S of Narcolepsy

A
  • sleepiness
  • slurred speech
  • slackening of facial muscles
  • feeling of impending weakness of knees
  • paralysis + hallucinations
  • performance is impaired
  • awaken feeling refreshed
  • do not tolerate irregular sleep-wake patterns such as shift work
31
Q

Treatment for Narcolepsy

A

-CNS stimulants such as methylphenidate (Ritalin)

32
Q

Parasomnias

A

common sleep disorders that happen during sleep

  • sleepwalking
  • sleep-talking
  • bruxism
  • night terrors
  • REM sleep behavior disturbances
  • Enuresis (bedwetting)
33
Q

Parasomnia: Sleepwalking

A
  • In NREM sleep 1 to 2 hours after person falls asleep
  • if dangerous, given medication to suppress the deepest stage III NREM sleep
  • can be triggered by stress, fatigue, and some drugs
34
Q

Parasomnia: Sleep-talking

A

in NREM sleep just before REM

35
Q

Parasomnia: Bruxism

A

grinding and clenching of the teeth in NREM sleep

-can erode tooth enamel and loosen the teeth

36
Q

Parasomnia: Night Terrors

A

sudden arousal (usually children) with activity, hallucinations, and expression of terror with no memory of event

37
Q

Parasomnias: REM Sleep Behavior Disturbances

A

violently acts out dream

38
Q

Parasomnias: Enuresis

A

(bedwetting)

  • most during NREM sleep early in night
  • most outgrow, patients
39
Q

Disorders that are Provoked by Sleep

A
  • Coronary Artery Disease
  • Asthma
  • COPD
  • Diabetes
  • Gastric + Intestinal Ulcers
  • Peptic Ulcers
40
Q

Disorder Provoked by Sleep: Coronary Artery Disease

A
  • during REM sleep

- dreams may increase heart rate, and provoke angina and ECG changes

41
Q

Disorder Provoked by Sleep: Asthma

A
  • may experience bronchospasm during REM sleep

- asthma attacks at night as esophageal sphincter relaxes and reflux results

42
Q

Disorder Provoked by Sleep: COPD

A

-experience lower oxygen tension and increased carbon dioxide retention during sleep, especially during REM sleep

43
Q

Disorder Provoked by Sleep: Diabetes

A

blood glucose levels vary during the night

44
Q

Disorder Provoked by Sleep: Gastric and Intestinal Ulcers

A

during REM sleep people with duodenal ulcers secrete up to 20 times more gastric acid

45
Q

Disorders Provoked by Sleep: Peptic Ulcers

A

also contributes to increased acid producing nocturnal epigastric pain and sleep loss

46
Q

Planning Interventions/ Implementation

A
  • cluster/schedule nursing care to avoid interrupting sleep
  • create a comfortable/ restful environment
  • promote comfort/ relaxation
  • support bedtime rituals/ routine
  • offer foods that promote sleep
  • teach about sleep hygiene
  • administer/ complete client teaching about sleep-inducing medications
  • “iCare”
  • “quiet heals” (Nsg Units have certain quiet times of the day)
47
Q

Prescription Medications

A
  • Nonbenzodiazepines
  • Benzodiazepines
  • Barbiturates
48
Q

Nonbenzodiazepines

A
  • sedative/ hypnotic
  • short half life, eliminated from the body quickly and do not cause “hangover” (daytime sleepiness)
  • Ambien, Sonata, Lunesta
49
Q

Benzodiazepines

A
  • sedative/ hypnotic
  • both long-acting and short-acting drugs
  • long-acting medications linger in the body and potentially cause daytime drowsiness
  • Valium, Xanax, Ativan
50
Q

Barbiturates

A
  • sedative/ hypnotic
  • anticonvulsants
  • rarely prescribed for insomnia because of risk of addiction, abuse and overdose
  • Nembutal, Seconal
51
Q

Non Prescription OTC Sleep Medications

A

sleep medications usually contain an antihistamine, which may induce drowsiness that lasts into the next day

  • Benadryl, any “pm” meds
  • Melatonin, Herbal sleep aids

Nursing 171 (38 decks)

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