Sleep/Rest Objectives Flashcards
The nurse is preparing to teach a client about the important of rest and sleep. Which statement made by the client would indicate the need for further teaching?
The client verbalizes that circadian rhythms do indeed influence sleep.
The client suggests that their Reticular Activating System is responsible for maintaining restfulness.
The client verbalizes that they may be less likely to develop an infection if they sleep less than 5 hours per day.
The client suggests they it may be easier to gain weight if they do not get enough regular sleep.
ANSWER: C
When adequate sleep is not maintained the bodies ability to maintain glucose is lessened, therefore responds with insulin resistance. This leads to reduced energy expenditure, all of which can lead to obesity and type 2 diabetes.
All of the other options suggest adequate information.
Reticular Activating System (RAS) are _____ . System includes which part of brain _________ and is responsible for
collection of nerve cell bodies within the brainstem,
medulaponsmidbrainhypothalamus
maintaining wakefulness
Bulbar Synchronizing Region (BSR)
release ___________. These are can cause either _______ or inhibition.
neurotransmitters
excitation
Which neurotransmitters
does BSR release?
Excitation Norepinephrine Acetylcholine Dopamine Serotonin Histamine
Inhibition
GABA
What is a biorhythm based on the day–night pattern in a 24-hour cycle
circadian rhythm
Circadium rhythm is regulated by_____ that respond to
cells in hypothalamus
respond to light
is generally the restful phase of sleep in which physiological function is slow.
NREM
During this phase of sleep, muscles relax; body temperature lowers; and heart rate, respirations, and blood pressure decrease.
NREM
The type of sleep is sleep is essential for mental and emotional restoration
REM
this gland secretes melatonin
pineal gland
REM sleep recurs about every ___ min and lasts ___ to ___ min
90
5-30
Which stage constitutes 75 - 80% of sleep
NREM
What stage of NREM is
This stage composes about 10% of sleep
(10% of 8 hours = 48 minutes total)
Person reaches greatest depth of sleep – Delta Sleep
Arousal is very difficult
Pulse/RR drops 20 -30% below waking hours rates.
B/P decreases
Metabolism and body temp decreases
If people are awakened during this stage, they do not adjust immediately, feel groggy & disoriented.
Children experience – bedwetting or sleep walking (somnambulism).
What stage sees
Eyes dart back/forth Twitching of small muscles (face) Immobile large muscles Respirations irregular/apnea Pulse rapid/irregular B/P increases or fluctuates Metabolism and body temp increase Gastric secretions increase
REM
The nurse is performing parent teaching to the parent of a client recently diagnosed with somnambulism. The nurse knows that teaching has occurred when the parent verbalizes the following: Select all that apply.
A complete sleep cycle is 90-100 minutes.
It may be harder for my child to wake up when she is in stage 4 of sleep.
Muscles in the face are likely to twitch during REM sleep.
If my child were to sleepwalk, it will most likely occur during NREM sleep stage 3.
ALL
complete sleep cycle is 90-100 minutes.
It may be harder for my child to wake up when she is in stage 4 of sleep.
Muscles in the face are likely to twitch during REM sleep.
If my child were to sleepwalk, it will most likely occur during NREM sleep stage 3.
Age where
Sleep pattern- sleep through the night by 6 months
10-12 hours night/ 2-3 daytime naps
Infants
Age where
Sleep patterns -12 hours per night decreasing to 8-10 as they reach preschool age
Toddler
True or False:Although sleep may become more difficult, the need to sleep does not change with age
True
Seen in older patients with Alzheimer’s disease
Not a sleep disorder directly, it refers to a pattern of symptoms; e.g., agitation, anxiety, aggression, and sometimes delusions
Occurs in the late afternoon
Can last through the night, further disrupting sleep
Sundowning Syndrome
More spontaneous awakenings occur during this stage than any other.
REM
Loss of _______sleep impairs memory and learning
REM
What is REM rebound
When A person who is deprived of REM sleep for several nights —that is, spend a greater amount of time in REM sleep on successive nights, keeping the total amount of REM sleep constant over time.
what natural hormone declines in latter decades of life
melatonin
Two groups of sleep disorders
Dyssomnias and Parasomnias
Disorders including: insomnia, sleep–wake schedule (circadian) disorders, sleep apnea, restless legs syndrome, hypersomnia, and narcolepsy.
Dyssomnias
what is parasomnia
Patterns of waking behavior that appear during sleep (sleepwalking)
What is the predominant complaint of dissatisfaction with sleep quantity, associated with the inability to fall asleep, remain asleep, or go back to sleep.
Insomnia
Etiologies of Insomnia
medsor inadequate sleep hygiene (e.g., watching TV in bed, sleeping with smartphone nearby, drinking caffeine-containing beverages before bedtime).
a disorder of the central nervous system characterized by an uncontrollable movement of the legs while resting or before sleep onset.
Restless Legs Syndrome (RLS)
unpleasant creeping, crawling, itching, tingling or burning sensations in the legs is relieved only by moving and stretching, which prevents the person from relaxing and falling asleep.
Restless Legs Syndrome (RLS)
People with RLS should avoid
stimulants (e.g., caffeine)
not actually a sleep disorder but rather, in NANDA-I terms, a human response to prolonged sleep disturbances (e.g., insomnia and parasomnias), involving NREM or REM deprivation, or both.
Sleep Deprivation
Illness and hospital care are common causes of
Sleep Deprivation
excessive sleeping, especially in the daytime.
Hypersomnia
Common causes of hypersomnia
sleep apnea, narcolepsy, and snoring; disorders of the central nervous system, kidney, or liver; and metabolic disorders (e.g., diabetic acidosis and hypothyroidism). Hypersomnia can also be a symptom of depression.
a periodic interruption in breathing during sleep
Sleep apnea
Sleep disorder that may result in cardiac dysrhythmias (irregularities) and increases in pulse and blood pressure. Many people with sleep apnea complain of unrefreshed sleep, fatigue and morning headache, and easily falling asleep during sedentary activity;
Sleep apnea
diagnosed clinically by reports of at least five witnessed breathing interruptions or awakenings due to gasping or choking events per hour
Obstructive Sleep Apnea OSA
treatment for OSA
surgery to remove obstruction within the airway.
Other treatments include the following:
Applying continuous positive airway pressure or bilevel positive airway pressure treatment. This is a device that delivers oxygen using forced air pressure and keeps the airways open.
Oral appliance therapy to pull the tongue forward or adjust the space in the pharyngeal space.
Advising the patient to avoid alcohol and smoking and lose excess weight
What is happening:the soft tissue of the pharynx and soft palate or other structures in the throat area (deviated nasal septum, enlarged tonsils) collapse and obstruct the airway during sleep, but the person continues to try to breathe
OSA
a chronic disorder caused by the brain’s inability to regulate sleep–wake cycles normally. The distinction between being asleep and being awake are blurred.
Narcolepsy
may be caused by rapid time-zone changes (jet lag), shift work, or a change in total sleep time from day to day.
Sleep–Wake Schedule (Circadian) Disorders
occur when a disease causes alterations in sleep stages or in quantity and quality of sleep.
Secondary Sleep Disorders
Common secondary sleep disorders
Depression
Hyperthyroidism - Increase in metabolic rate - can’t fall asleep
Hypothyroidism - Decrease in REM sleep
Pain
Risk factors for sleep apnea
Weight
–Neck size
–Being male
– Lack of airflow through the nose and mouth for periods of 10 seconds or longer during sleep
Sleep apnea
causes of sleep apnea
Changes in airway during sleep Overweight/obesity Shape of head and neck Aging process Air flow, oxygen levels
one of the most common sleep studies performed in a sleep lab, records brain wave activity, eye movement, oxygen and carbon dioxide levels, vital signs, and body movements during the sleep phases. EEG, EMG and EOG
Polysomnography
Diagnosis: Use for patients who have a disruption in the amount of quality of sleep to the extent that it impairs functioning.
Insomnia
Diagnosis: Use as the nursing diagnosis when the patient’s amount, consistency, or quality of sleep is decreased over prolonged periods of time.
Sleep Deprivation
Diagnosis: Use as the diagnosis when assessment data point to a time-limited sleep problem due to external factors (e.g., inability to sleep in the unfamiliar hospital environment).
Disturbed Sleep Pattern
Use this diagnosis when a client without a sleep disorder desires improved quality or duration of sleep.
Readiness for Enhanced Sleep
a term referring to interventions used to promote sleep.
Sleep hygiene
These medicines have a short half-life; they are eliminated from the body quickly and do not cause daytime sleepiness. Examples are
Nonbenzodiazepines
zolpidem tartrate (Ambian) and zaleplon (sonata)
is the first-line treatment for insomnia.
Benzodiazepines class of: sedative/hypnotics
