Sleep and Sensory Flashcards
The nurse is caring for a client who is placed in soft-wrist restraints. Which action by the nurse is appropriate concerning restraint use?
- attach restraints to walker
- ask for restraint protocol from physician
- document behaviors nurse imagines restraints would prevent
- provide a trial release
Provide a trial release
3 components of sleep health
sleep latency, nocturnal awakenings, ease of waking
3 consequences of poor sleep
increased BP, increased cortisol, increased cytokines
Proportion of REM to non-REM
30% REM : 70% non-REM
NREM [increase/decrease] in brain activity from wakefulness
decrease
Muscle tone in REM sleep is [slightly lower/absent]
absent
HR and BP in REM [decreases and stable or increases and highly variable]
increases and highly variable
NREM body temp [regulated at lower level/is not regulated]
regulated at lower levels
blood flow to the brain in REM [increases depending on brain area/decreases from wakefulness]
increases from NREM depending on the brain area
Which of these components is lower in REM than NREM:
- brain activity
- HR/BP
- Sympathetic nerve activity
- Muscle tone
Muscle tone
1/3 of adults get how much sleep
6 hours or less
average sleep latency
10 minutes or less
sleep latency less than 5 minutes
sleep deprivation
sleep latency more than 30 minutes
insomnia
typical nocturnal awakenings
1-2 brief events/night
how long is typical circadian rhythm
24 hours
hormones related to circadian rhythm
melatonin, cortisol (among others)
circadian rhythm develops at which age
2-3 months
infants begin sleeping through the night at what age (in theory)
6-9 months
average sleep time of newborns and infants
13 hours
toddler and preschool have what percentage of REM sleep
30%
adolescents need how many hours of sleep
9, but rarely get it
adult sleep duration
7 hours average
older adult sleep latency
longer
recommended last time to drink caffeine
6 hours before bed
do benzodiazepines and alcohol promote good sleep
no
negative effects of alcohol on sleep
- sedation instead of sleep – no REM
- rebound awakening
- poor sleep while in recovery from chronic alcohol overuse
insomnia treatments
CBT-I
medications
hypopnea
shallow breathing
apnea
absence of breathing
consequences of sleep apnea
hypertension
increased risk of stroke
impaired concentration
cataplexy
extreme muscle weakness, present in 70% of narcolepsy patients
onset of REM in narcolepsy
within 20 minutes
sleep attacks
extreme urge to fall asleep
sleep paralysis
you cannot move or speak as you are waking up or falling asleep.
RLS
restless leg syndrome – unpleasant sensations lead to urge to move them (maintain normal iron levels)
PLMD
periodic limb movement disorder: repetitive dorsiflexion of foot and flexion of knee during sleep
BEARS for sleep assessment
Bedtime Excessive daytime sleepiness Awakenings Regularity and sleep duration Snoring
*** sensory perception
use of senses to receive information facilitated by the reticular activating system (RAS)
perception
how the brain processes information
primary sense of newborns and infants
touch (for bonding and nursing)
sensory function [increases/decreases] in old age
decreases
alarm fatigue
sensory concept of adaption: not recognizing an alarm when it rings for the hundredth time in an hour
which sense(s) does it disrupt: alcohol
touch (peripheral neuropathy with chronic overuse)
which sense(s) does it disrupt: smoking
taste and smell
which sense(s) does it disrupt: cocaine
smell
which sense(s) does it disrupt: diabetes
vision and touch
which sense(s) does it disrupt: medications
hearing, sedatives dull all senses
overload or deprivation: insomnia
overload
hallucination
altered sense
delusion
altered thoughts
match the test with the sense: Snellen
vision
match the test with the sense: Weber and Rinne
hearing
match the test with the sense: wisp of cotton
touch
match the test with the sense: two pins
touch
match the test with the sense: differentiate three smells
smell
match the test with the sense: differentiate three tastes
taste
glasses, large print, color coding
vision sensory aids
hearing aid, speak facing patient, amplify home sounds
sound sensory aid
fresh food, minimize noxious stimuli
smell sensory aid
regular timing of meals, proper temperature of food, fresh foods
taste sensory aid
hair brushing, turning, massage, clothing
touch sensory aid
which side do you stand on to assist a visually impaired person with ambulation
nondominant
what will a visually impaired person do with their nondominant hand
grab your arm (so they have choices on when to release)
