Week 9 Basic Need Sleep Flashcards
Class of drug that cuases insensibility to pain and induces sleep
Hypnotic
A state of mental, physical, and spiritual activity that leaves the individual feeling refreshed, rejuvenated, and ready to resume activities of the day
Rest
Medication that produces a calming effect by becreasing functional activity, diminishing irritability and allaying excitement
Sedative
State marked by reduced consiousness, diminished activity of the skeletal muscles and depressed metabolism
Sleep
A state of strong desire to sleep, or sleeping for unsually long periods
Somnolence
Stage lasts a few minutes
It includes lights level of sleep
Decreased physiological activity begins with gradual fall in vital signs and metabolism
When awakened person feels as if day dreaming occurred
Stage 1 NREM
Stage lasts 10 to 20 minutes It is a peroid of sound sleep Relaxation progresses Body functions continue to slow Arousal remains relatively easy
Stage two NREM
Stage lasts 15-30 minutes Initial stages of deep sleep Muscles are completely relaxed Vital signs decline but remain regular Sleeper is difficult to arouse and rarely moves
Stage 3 NREM
Stage lasts approximately 15-30 minutes
Is it the deepest stage of sleep
Is sleep loss has occurred, sleeper spends considerable part of night in this stage
Vital signs are significantly lower than during waking hours
Sleep walking or enuresis sometimes occur
It is very difficult to arouse sleeper
Stage 4 NREM
Occurs after stage four
Usually begins about 90 minutes after sleep has begun
Duration increases with each sleep cycle and averages 20 minutes
Vivid full color dreaming occurs
Stage is typified by rapid moving eyes
Fluctuating heart rate, respiratory rate, BP, loss of skeletal muscle tone, increased gastric secretions
Very difficult to arouse sleeper
REM
State the function of sleep
Physiological and psychological restoration
Maintenance of biological process
The body conserves energy
Important for learning, memory and adaptation to stress
Changes that occur in sleep patern in neonates
Up to age of 3 months neonates average about 16 hours of sleep each day
Sleep cycle 40-50 minutes
Approximately 50% of this sleep is REM which stimulates higher brain centers essential for development because the neonate is not awake long enough for significant external stimulation
Changes that occur in sleep patern in infants
Usually develope a patern of sleeping through the night by 3 months
Usually take several naps during the day
8-10 hours during night plus naps = 15 hours
Awakening commonly occurs early in the morning although it is not uncommon for an infant to awake during the night
Changes that occur in sleep patern in toddlers
By the age of 2 children typically sleep through the night and take daily naps
Total sleep averages 12 hours q day
After age of 3 children often give up daytime naps
Common to awaken during the night
May be resistant to going to bed at night because they need autonomy or separation anxiety
Changes that occur in sleep patern in preschoolers
Sleep about 12 hours q night
By the age of 5 children rarely take daytime naps
May have difficulty relaxing after a long active day, bedtime fears, awaken at night or have nightmares
Partial awakening frequent
In awake period child crys, walks around, and speaks unintelligibly, sleep walking, enuresis
Changes that occur in sleep patern in adolescents
On average teens get 7 hours of sleep or less
Alcohol use, electronics, mood changes etc
Changes that occur in sleep patern in young adults
Average 6 to 8 1/2 hours of sleep q day
Common for
Stresses lead to sleep loss and medication use
Pregnancy increases need for sleep and rest
Changes that occur in sleep patern in middle adulthood
Total time spent sleeping at night declines
Insomnia is common
Anxiety depression or physical illness cuase sleep disturbances
Menopause may cause insomnia
Changes that occur in sleep patern in older adults
Sleeping difficulties increase
Experience wakening, desychronized cercadian rythm that alter sleep wake cycle
Awaken more at night and take longer to fall asleep
Tendency to nap increases
Presence of chronic illness often results in sleep disturbances
What are several common sleep disorders
Insomnia Narcolepsy Sleep apnea Hypersomnia Parasomnia
Veriety of sleep problems, night terrors, sleep walking
Parasomnia
Fall asleep at random doing any activity
Narcolepsy
Fall asleep very easily
Hypersomnia
Difficulty falling asleep of waking frequently
Insomnia
Airway closes periodically during sleep
Sleep apnea
Indentify essential data to be collected when preforming a nursing history of a pt. With basic need for sleep
Description of sleeping problem Usual sleep patern Physical and psychological illness Current life events Emotional and mental status Bedtime routines Bedtime environment Behaviors of sleep deprivation
Assessment finding of sleep deprivation
Causes include illness Emotional distress Medications Environment disturbances Work pressure Physiological symtoms: Blurred vision, fine motor clumsiness, decreased reflexes, slowed response time, decreased reasoning and judgement, decreased auditory and visual alertness, cardiac arrhythmias
Psychological symptoms: confused and disoriented, increased sensitivity to pain, irritability- withdrawn, apethetic, agitation, hyperactive, decreased motivation, excessive sleepiness
Saftey measures for sleep in a health care setting
Monitor airway RR
And breath sounds should be monitored post op
Recommend lifestyle changes to patients with OSA ( sleep hygiene, alcohol moderation, smoking cessation, weight loss)
CPAP for patients with OSA delivers room air at high pressure
Identify health promotion behavoirs in relation to rest and sleep
Environment controls Promotion of safety Promotion of comfort Established periods of rest and sleep Stress reduction Bedtime snacks Pharmacological approaches
Trade name for zolpidem
Ambien
Side effects of zolpidem/ Ambien
Abnormal thinking, sleep driving and sleep eating, confusion, complex sleep related reactions, irritability, poor coordination
Nursing implications
Teach that there are complex sleep related behaviors
Asses impaired coordination, suicidal thoughts,
Severe adverse effects, angioedema, anaphylaxis
Use for abien/ zolpidem
Insomnia
Which sleep cycle has to do with tissue restoration and which sleep period has to do more with cognitive restoration
Nrem- tissue restoration
REM.- cognitive restoration
