Sleep Flashcards
What is the stage 1 sleep phase?
Falling asleep
lightest sleep
Only lasts a few minutes
What is the stage 2 sleep phage?
Heart rate slows
Body temperature drops
- Non-REM
- Relaxation begins
What is the stage 3 sleep phase? 5
Deepest sleep
- Non-REM
- Muscles, and tissue repair
- Immune system strengthens
- Vital sings are lower than waking hours
Rapid eye movement
The body is paralyzed and dreams begin
What is the stage 4 sleep phase? 4
Dreams begin
- REM sleep
- Body is paralyzed
- BP, HR and RP are increased/rapid fluctuation
- Very difficult to wake up
Sleep disorders 5
Insomnia
Apnea
Polysomnography
Narcolepsy
Hypersomnia
Sensory overload
In the hospital setting, the client’s sleep is interrupted multiple times due to the need for complex interactions and procedures.
Insomnia? 3
- Difficulty falling asleep or staying asleep
- Frequent awakenings
- Feeling tired when waking
Can affect physical, mental, emotion
Sleep apnea? 2types
Lack of airflow through the nose or mouth for 10 seconds
to 1-2 minutes
Obstructive apnea(OSA) the most common
-Obesity, HTN, smoking, age, heart failure
Central apnea(CSA) impairment of brainstem
-Brainstem injury, stroke, obesity
Narcolepsy? 4
- Sudden sleepiness
- Sudden periods of sleep
- Difficulty staying awake
- Overwhelming wave of sleepiness at an inappropriate time
They can go into REM sleep within 15 minutes
Hypersomnia?
Excessive daytime fatigue without improvement after more sleep
Associated poor memory,depression.
Function of sleep 3
- Memory Consolidation/ Brain development
- Preparation for wakefulness
- Restores biological processes/repair and renewal
What are some BAD habits for sleep? 6
- Caffeine
- Stress
- Heavy food
- Heavy training at night time
- Alcohol
- Blue light/devices
What are GOOD habits for sleep? 5
- Maintain sleep routine( get up at the same time)
- Excise in the daytime
- Cool and darkroom
- Relaxing bath
- Comfortable sleep aids
Sleep pattern history, routine, has it changed?
Why does it important to ask?
Effect on patient functioning and quality of life.
Why does it important to assess?
Emotional and mental status
How is it related to sleep disorders?
-A lack of sleep leads to moody, emotional, grouchy
Depression, and anxiety (Chronic)
Good sleep cause increased mental perfomance
Sleep hygiene assessment 6
- Consider medication use
- Loss of routine
- Emotional and mental stress
- Environmental stimulation
- Timing of exercise
- Diet and substance use
Consider medication use
Why is it important related to sleep?
-Sleep aid medication maybe don’t help pt sleep
Or maybe too early to take or too late to take
Environment stimulation
How is it affect healthy sleep?
Timing of exercise
How is it affect healthy sleep?
a) Polysomnogram?
b )Actigraphy?
a) Measures eye movement(EOG)
Muscle tone changes(EMG)
Neuroglial electrical activity(EEG)
b) Measures sleep time(EOG)
Efficiency
Number and duration of awakenings
Levels of activity and rest for prolonged periods of time
What is the nursing diagnoses of sleep disorders? 4
- Impaired sleep
- Fatigue
- Impaired alertness
- Sleep deprivation
how does sleep distraction affect patient?
How does sleep distraction affect the health care workers?
Too long or repeated shifts reduce the opportunity for sleep
Shorten recovery time in the healthcare workers
- Can result in cognitive impairment
- Impair performance/decision making, memory planning
- Lead accidents both in and off the job
Central sleep apnea causes what? 5
- Opioid overdoes
- Congestive heart failure
- Reduction of the brain’s transmission
- Brainstorm injury
- Stroke
What is the first-line sleep aid medication for old pt?
Controlled release melatonin
- Cost-effective
- Non-habit forming
- Few adverse effects
Pt needs to wake up for the oral medication, but the pt was in stage 3 sleep.
What to expect?
The pt experience mental cloudiness for 30 to 60 min.
-stage 3 is the deepest stage of sleep
The pt who works overnight shifts increased the risk of what disease? 3
- Diabetes mellitus
- Obesity
- Cardiovascular disease
Why do shift workers often experience obesity? 3
- Poor diet
- Lack of exercise
- Hormone imbalance
OTC sleep aid medications every evening can cause what? 5
- Urinary retention
- Daytime drowsiness
- Dry mouth
- Visual disturbances
- Constipation
Excessive smartphone use risk of what?
Depression and poor sleep
An old adult wakes up frequently during the night.
This is because they tend to spend more at what stage of sleep?
Stage 2
contribute to them to frequent awakenings
-environmental factors, such as noise
Nursing diagnoses process
Make sure the evidence I have is going to meet the practice for the diagnoses
See causes of cluster data
What I can apply to the whole cluster
Only then pick diagnoses for the last
A pt comes to the clinic with concerns of feeling constantly tired.
What assessment is the best for this pt’s sleep concern?
Describe for me a recent night’s sleep.
How is this similar or different from your usual sleep?
Do you have a hard time falling asleep or staying asleep?
This is NOT GOOD! because YES or NO question.
The nurse assess the pt who had sleep difficulties since losing her job.
What should the nurse include for the assessment? 5
Sleep patterns before and after the loss
Meaning of the sleep loss
Medications used for sleep
How she feels during the day
Past medical history of acute and chronic pain
Why does the promote bedtime routine important?
Tell body to time to go to sleep
brush teeth, get water, read a story, light out etc
When planning care to sleep deprivation,who should involved the pt care plan?
Sleep partner which sleeps next to the p
-Whoever share the room with the pt
What example interventions for impaired sleep? 5
- Sleep hygiene education
- Environment control
- Promote bedtime routine
- Daytime physical activity
- Stress reduce technique
What we can do with interventions at the hospital setting for the pt has impaired sleep?
- Environmental controls/close door, dim lights
- Promote comfort and manage pain
- Minimize sleep interruptions/cluster nursing care
For the medical diagnostics, what tool do Dr use?
Polysomnogram and Actigraph
What is the difference between a polysomnogram and an actigraph?
Poly looks at SMLL details
Acti looks at the BIG pictures
Symtoms of sleep apenea?
- Daytime sleepiness
- Fatigue
- Irritability
- Depression
- Snoring
What is the benefit of sleep? 6
- Increases mental performance
- Restores energy
- Strengthens the immune system
- Reduce stress
- Maintain hormonal balance
- Helps the storage of long-term memory
A nurse observes some involuntary muscle jerking in a sleeping PT.
which stage of sleep?
Stage 1
In the other stages, the muscles proceed from a relaxed state to large muscle immobility
A nurse is discussing with an older female patient the factors that affect sleep.
What fact does the nurse teach her?
Aging decreases the amount of REM sleep
What disease would be considered at a higher risk for having sleep disturbances?
- Uncontrolled hypothyroidism/decreased NREM
- Coronary artery disease/pain
- Gastroesophageal reflux (GERD)/awaken at night with heartburn pain
What questions to ask a patient regarding sleep?
What time do you go to bed?
What time do you usually wake up?
How long does it take you to fall asleep?
Do you awaken during the night?
How long have you had this sleep pattern?
Do you feel you get enough sleep (quantity)?
Also check mental states
Describe for me a recent night’s sleep. How is this similar or different from your usual sleep?
This is assesment stage, so pick something indicate about asses.
Do you have a hard time falling asleeo or staying asleeo?
is not correct. Because this is
What is a polysomnogram?
Measures eye movements
Muscle tone changes
Neurological electrical activity
Small details
What is an actigraphy?
Measure sleep time
Number of the duration of awakenings
levels of activity
Rest periods
Looks at the BIG pastures
What is the difference between sleep and rest?
Rest is relaxed physically and mentally while alert and awake
Sleep is reduced consciousness
What happens in relation to body and brain during NREM?
active body quiet brain
Active body quiet brain
When the cyclic sleep repeats, what happens?
REM increases
What happens in relation to body and brain during REM?
active brain quiet body
Active brain quiet body
Less REM means what?
Less memory info, processing and less storage
Less memory info, processing and less storage
How does menopause affect sleep?
less estrogen means less sleep
Less estrogen means less sleep
Newborn babies’ sleeping pattern
10-18 hours
50%REM 50%NonREM
Skips stage 1-4
Irregular breathing/brief apnea
Infant sleep pattern
Take a several naps
8-10 hours total
30%REM
school-aged kid sleep pattern
less than 7years
Sleep 12 hours of sleep
Encourage or do a quiet activity before bed
Fear death and nightmares occur
7 years and more
Often resist sleep(independent)
How many hours do adolescents sleep?
9-10 hours of sleep with nocturnal emissions, late sleep cycles and daytime sleepiness
9-10 hours of sleep with nocturnal emissions, late sleep cycles and daytime sleepiness
Elderly sleep pattern
Total 6 hours sleep, 25% REM
Stage 3 and 4 decreased
Awake often at night
Tend to nap increase (because awaken during the night)
Toddler sleep pattern
Take some naps
total 12 hours through the night
REM decrease
Young adult sleep pattern
mid 20s
6-8.5 hours
about 20% REM
The stress of job, family and social relationships often causes insomnia
Middle adult sleep pattern
40-65
Decrease total time of sleep
REM begins fall
A pt is diagnosed with narcolepsy.
The nurse’s primary intervention should address the pt is
1: Inability to provide seld=care
2: Altered thought processes
3: Excessive fatigue
4: Risk of injury
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