rest and sleep, sexuality Flashcards
physiology of sleep
- circadian rhythm
- cyclical rhythms
- biological clock
- stages of sleep
- biological clock; regular bodily rhythms that occur on a full 24-hr cycle
- fluctuations in a person’s heart rate, blood pressure, body temperature, hormone secretions, metabolism, and performance and mood depends on part
circadian rhythm
- fundamental to the functioning of life and to the organization and coordination of behavior.
- Simple behavioral functions, such as timing active and inactive periods during the day/night cycle to maximize productivity and minimize risk rely on internal clock functions.
biological clock
two phases: NREM and REM
four stages:
NREM stages 1 - 2: lighter sleep
NREM stages 3 - 4: slow-wave sleep
stages of sleep
characterizes four stages of sleep
NREM (non-rapid eye movement)
- person is in a transitional stage between wakefulness and sleep.
- The person is in a relaxed state but still somewhat aware of the surroundings.
- Involuntary muscle jerking may occur and waken the person.
- The stage normally lasts only minutes.
- The person can be aroused easily.
- This stage constitutes only about 5% of total sleep.
NREM stage 1
- person falls into a stage of sleep.
- The person can be aroused with relative ease.
- This stage constitutes 50% to 55% of sleep.
NREM stage 2
- depth of sleep increases, and arousal becomes increasingly difficult.
- This stage composes about 10% of sleep.
NREM stage 3
- person reaches the greatest depth of sleep, which is called delta sleep.
- Arousal from sleep is difficult.
- Physiologic changes in the body include the following:
Slow brain waves are recorded on an EEG.
Pulse and respiratory rates decrease.
Blood pressure decreases.
Muscles are relaxed.
Metabolism slows and the body temperature is low.
This constitutes about 10% of sleep.
NREM stage 4
- stage that constitutes 20% to 25% of a person’s nightly sleep
- person is difficult to arouse during this stage
- Occurs at the end of each 90-minute cycle
- Increased brain activity and muscle atonia
REM (rapid eye movement) or REM sleep
Purpose of sleep
Restoration, memory consolidation, and preparation
a decrease in the amount, consistency, and quality of sleep; results from decreased REM or NREM sleep
Negatively alters body functions
sleep deprivation
- Occur in nonrapid eye movement (NREM) and rapid eye movement (REM) sleep
- Important for learning, memory, and adaptation to stress
dreams
common sleep disorders
- insomnia
- narcolepsy
- sleep apnea (central vs. destructive)
- sleep deprivation
- potentially serious sleep disorder in which breathing repeatedly stops and starts.
- If you snore loudly and feel tired even after a full night’s sleep, you might have sleep apnea.
Obstructive
Central
Mixed
CPAP/BiPap
sleep apnea
- more common form that occurs when throat muscles relax
- caused by a partial or complete blockage of the airways during sleep. During sleep, a person’s throat muscles relax allowing the tongue and/or fatty tissues of the throat to fall back into the airways and block airflow.
Obstructive sleep apnea
occurs when your brain doesn’t send proper signals to the muscles that control breathing
more of a communication problem
central sleep apnea
- combination of both obstructive and central sleep apnea symptoms.
- Some patients being treated for obstructive sleep apnea with the use of CPAP machines develop symptoms of central sleep apnea upon PAP therapy
mixed sleep apnea
- definitive treatment of moderate or severe OSA
- noninvasive and consists of a mask connected to an air pump that is worn during sleep. This device delivers positive air pressure that holds the airway open
CPAP/BiPap
16 hrs a day
neonates
8-10 hrs a night for a total of 15 hrs/day
infants
total 12 hrs a day plus a nap
toddlers
12 hrs a night
preschoolers
9-10 hrs
school age
7 1/2 hrs
adolescents
6 to 8 1/2 hrs
young adults
total number of hrs declines
middle and older adults
chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep
Excessive daytime sleepiness is main complaint reported
Could be mistaken for being lazy or drunk
Major safety concern-This patient needs to avoid factors increasing drowsiness like taking long drives, eating heavy meals, drinking alcohol, sitting for long periods of time
We want to ask this patient if they have a family hx of this
- Will need stimulant medications to keep patient awake
- Encourage 20 minute naps when needed
narcolepsy
Factors affecting sleep
- Physical Illness
- Medications
- Lifestyle
Diet, Exercise - Stress
- Environment
- Sleep history
- Sleep pattern and quality
- Description of sleeping problem
- Sleep diary
- Physical illness
- Medications
- Current life events
- Emotional and mental status
- Bedtime routines
- Bedtime environment
- Behaviors of sleep deprivation
assessment of sleep
older adult considerations
- Decline in REM sleep
- Circadian rhythms change as the body ages
- Still require 7-8 hours of sleep per day
- Sleep disturbances are often related to illnesses, medications, and losses
- More prone to RLS
patient expectations
assess any needs and preferences
- acute confusion
- ineffective coping
- fatigue
- insomnia
- disturbed sleep problem
- sleep deprivation
- ineffective health maintenance
- readiness for enhanced sleep
nursing diagnosis
nursing interventions for sleep
- Health promotion
- Environmental controls
- Promoting bedtime routines, safety, comfort, and activity
- Decreasing stress
- Bedtime snacks
- Pharmacological approaches to promoting sleep
- Managing environmental stimuli
- Safety
Nursing interventions: acute care
- Restorative or continuing care
- Maintaining activity
- Reducing sleep disruption
Nursing interventions: comfort measures
Drugs that decrease REM sleep include barbiturates, amphetamines, and antidepressants. Diuretics, antiparkinsonian drugs, some antidepressants and antihypertensives, steroids, decongestants, caffeine, and asthma medications are seen as additional common causes of sleep problems.
Drugs that suppress REM sleep include barbiturates, amphetamines, and antidepressants. Diuretics, antiparkinsonian drugs, some antidepressants and antihypertensives, steroids, decongestants, caffeine, and asthma medications are seen as additional common causes of sleep problems.
drugs that affect sleep
interventions for sleep
- close doors to clients’ rooms
- keep doors to work areas on unit closed
- wear rubber-soled shoes
- turn off beside oxygen & other equipment not in use, and also room tv and radio
- turn down alarms and beeps
- avoid abrupt loud noises
- keep necessary conversions at lower levels
- conduct convos and reports in private areas
Part of a person’s personality and is important for overall health
sexuality
- state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity
- requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence
sexual health
- erectile dysfunction
- desire
- arousal
- orgasm
sexual dysfunction
Neurogenic problems, medications, or endocrine or psychogenic factors
erectile dysfunction
painful sexual intercourse
dyspareunia
spastic contraction or tightening of the vagina during or before penetration for intercourse
vaginismus
sexual development
- infancy and early childhood
- school-aged
- puberty
- adolescence
- young adult
- middle adult
- older adult
Have general questions regarding the physical and emotional aspects of sex
school-aged children
Need accurate information on sexual activity, emotional responses with relationships, sexually transmitted infections, contraception, and pregnancy
adolescence
intimacy and sexuality are issues for this group
young adulthood
Changes in physical appearance lead to concerns about sexual attractiveness
middle adulthood
Factors that determine sexual activity include present health status, past and present life satisfaction, status of intimate relationships
older adulthood
Describes the predominant gender preferences of a person’s sexual attraction over time
i.e., LGBTQ+, straight
sexual orientation
- Diabetes Mellitus
- Cancers
- Spinal Injury
- Heart Disease
- Substance Abuse
- Depression
- Stress
illness affecting sexual health
- Antibiotics
- Antihyperlipidemic
- Antihypertensives
- Diuretics
- Analgesics
- Antipsychotics
meds affecting sexual health
questioning for sexuality
- personal subject
- can be hard to address
- non-judgmental
- personal values
- satisfaction
Adequate knowledge regarding sexual functioning and sexual issues, well-developed communication skills, knowledge of areas to assess in regard to sexuality; personal comfort, and a caring, sensitive attitude
Nurses need to have what skills to feel comfortable addressing sexuality
Education:
- Medication expectations
- Avoid Alcohol and Tabaco
- Good Nutrition
- Sexual Activity when rested
- Pain Med if needed prior to sex
- Pillows and positioning for comfort
- Open communication with partner
- Encourage kissing, touching, and other tactile stimulation
- STDs/STIs
interventions for sexual issues
