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FUNDAMENTALS OF NURSING PRACTICE > Module 10: Sleep and Rest > Flashcards

Module 10: Sleep and Rest Flashcards

1
Q

This is delineated as one of the most basic requirements of life (entailed to cope with daily stresses and human survival). It has restorative properties and contributes to the client’s biopsychosocial world

A

Sleep

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2
Q

This transpires during sleep and aids in the promotion of good mental health and psychosocial integrity.

A

Cellular Restitution

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3
Q

According to Coliver et al, 2003 what are the benefits of a good or optimum sleep?

A

(1) Promotes good mental health and psychological integrity
(2) It is vital not only for optimal function but also ensures optimal physiological and psychological wellbeing (Robinson et al, 2005) as the rate of feeling of damaged tissue is greatest during sleep.
(3) Evidence for a beneficial role of sleep in cognition is rapidly emerging in the cognitive neuroscience literatures.
(4) This is important as the building blocks of learning, creativity and scientific discovery (Ellenbogen, 2005)

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4
Q

This results in the loss of sleep benefits for cognitive processes for memory and integration.

A

Sleep Deprivation

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5
Q

This is the cyclical physiological process that alternates with longer periods of wakefulness.

A

Sleep (historically considered or delineated as the state of consciousness but more recently sleep has then became considered as an altered state of consciousness in which the individual’s perception and action to the external environment is decreased.)

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6
Q

What does the sleep-wake cycle influence?

A

It influences and regulates physiological functions and behavioral responses.

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7
Q

What controls sleep?

A

The cyclic nature of sleep is thought to be the controlled by centers in the lower part of the brain, which is delineated as the reticular formation located at the brainstem.

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8
Q

What is the role of the reticular formation?

A

The reticular formation integrates sensory information from the peripheral nervous system (PNS) and relays the information to the cerebral cortex.

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9
Q

The upper part of the reticular formation is constituted of a network ascending nerve fibers known as the _____________________. This is involved with the sleep-wake cycle.

A

Reticular Activating System (RAS)

It is important to heed that an intact cerebral cortex and reticular formation are necessary for the regulation of sleep states.

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10
Q

These affect the wake cycle. For example, serotonin is delineated to lessen the response to the sensory stimuli and GABA is defined to shut off the activity in the neurons of the RAS.

A

Neurotransmitters

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11
Q

When darkness in preparation of sleep causes a decrease in the stimulus of the RAS, what happens?

A

The pineal gland and the brain secretes the natural hormone melatonin; hence prodding the person to be less alert. During sleep the growth hormone is also secreted and cortisol is inhibited

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12
Q

With the beginning of daylight, explain the state of melatonin.

A

Melatonin is in its lowest state in the body and stimulating hormones like cortisol are at their highest.

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13
Q

Wakefulness is also associated with what neurotransmitters?

A

Acetylcholine, Dopamine, and Noradrenaline

(a) Acetylcholine is released in the reticular formation.
(b) Dopamine is released in the midbrain.
(c) Noradrenaline is released in the pons.

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14
Q

What is the importance of neurotransmitters such as acetylcholine, dopamine and noradrenaline?

A

These are localized within the RAS and influences cerebral cortical arousal.

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15
Q

This is defined as the basic organization of normal sleep.

A

Sleep Architecture

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16
Q

What are the two (2) types of sleep?

A

(1) The non-rapid eye movement or the NREM sleep
(2) The rapid eye movement sleep or the REM sleep

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17
Q

He is the scientist that deliberately broke down the disparity between the Non REM and the REM stages.

A

Matt Walker

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18
Q

According to the scientist Matt Walker, what are the disparate subdivisions of non rapid eye movement sleep or NREM?

A

(1) Stage 01: Awake or Light Sleep
(2) Stage 02: Light Sleep
(3) Stage 03 or 04: Deep Sleep

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19
Q

How many people as per statistics dream black and white?

A

Twelve percent (12%)

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20
Q

According to the scientist Matt Walker, what happens when go into those light stages of sleep under NREM?

A

The heart rate starts to decrease and the body temperature starts to drop along with your electrical brain wave activity starts to slow down.

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21
Q

According to the scientist Matt Walker, what happens when go into those deep stages of sleep under NREM?

A

The brain erupts with potent brain waves where the body is recharged in terms of its patent immune system and cardiovascular system. Deep NREM sleep aids in consolidation of memories and fixates them in the neural architecture of the brain.

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22
Q

This is where we principally have the most vivid and hallucinogenic types of dreams because of the augmentation of brain wave activity. In this, we get a boost for creativity due to it deliberately stitching information thus generating solutions for previously difficult situations.

A

REM sleep (rapid eye movement sleep)

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23
Q

What is the relationship of NREM and REM sleep?

A

Both sleeps will deliberately play out to brain domination throughout the night. Hence, prodding the cerebral wall to become lost every 90 minutes and replayed every 90 minutes. Hence, producing a cycling architecture of human sleep.

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24
Q

What happens the ration between the NREM and REM during the 90minute sleep cycle?

A

It changes as we move across the night. The first half of the night, the majority of the 90 minute cycle is constituted of deep NREM sleep (stages 03 and 04). In the second half of stage, most of the 90 minute cycle are comprised REM sleep or dream sleep along with stage 02 of NREM sleep,

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25
Q

According to the scientist Matt Walker, a loss of 2 hours of sleep from an 8 hour sleep pertains that they have lost?

A

25% of their sleep (but because REM sleep comes in the second half of the night, they may have lost about 50% to 70% of their REM sleep)

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26
Q

What happens to the number of hours of sleep, presence of the REM sleep as you grow older?

A

It alters

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27
Q

What are the normal sleep requirements and patterns for neonates?

A

(A) 16 hours a day
(B) Constant sleeping during the first week
(C) 40 to 50 minutes per cycle
(D) Wakening after 1 or 2 cycles
(E) 50% is REM sleep

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28
Q

What are the normal sleep requirements and patterns for infants?

A

(A) 8 to 10 hours at nighttime with several naps
(B) 15 hours a day
(C) 30% of REM sleep

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29
Q

What are the normal sleep requirements and patterns for toddlers?

A

(A) 12 hours a day
(B) Gives up daytime naps
(C) Awakening during night is common
(D) Autonomy or fear of separation from the parents

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30
Q

What are the normal sleep requirements and patterns for preschoolers?

A

(A) 12 hours of sleep at nighttime
(B) 20% is REM
(C) Rarely takes daytime naps
(D) Difficulty relaxing
(E) Partial awakening due to nightmares, bed wetting

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31
Q

What are the normal sleep requirements and patterns for school age children?

A

(A) 9 to1 2 hours of sleep per day
(B) Resists to sleep

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32
Q

What are the normal sleep requirements and patterns for adolescents?

A

(A) 7 hours at nighttime
(B) Shortened sleep may cause accidents, reduced performance in school, use of alcohol or behavioral and mood problems

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33
Q

What are the normal sleep requirements and patterns for young adults?

A

(A) 6 to 8 1/2 hours per nighttime
(B) 20% is REM sleep
(C) Daytime Sleepiness

34
Q

What are the normal sleep requirements and patterns for middle adults?

A

(A) Sleeping at night begins to decrease
(B) Stage 4 of sleep begins to decline
(C) Sleep disturbances are common

35
Q

What are the normal sleep requirements and patterns for older adults?

A

(A) Complaints of sleeping difficulties increases
(B) Weakening, desynchronized circadian rhythm
(C) REM sleep is shortened
(D) Frequent awakening at night
(E) Frequency of naps

36
Q

What are the factors influencing sleep? Cite them all.

A

(A) Drugs and substances
(B) Lifestyle
(C) Unusual sleep patterns
(D) Emotional Stress
(E) Environment (can either promote or disrupt or hinder sleep such as physical noise within the external environment.
(F) Exercise and fatigue
(G) Food and caloric intake

37
Q

How does the environment impact sleep?

A

Environment (can either promote or disrupt or hinder sleep such as physical noise within the external environment. The presence of unusual stimuli can prevent people from sleeping. Hospital environments can be noisy hence special care should be employed to mitigate noise in the hallways and nursing stations.

38
Q

How does hospital temperature affect sleeping?

A

Discomfort from temperature and lack of ventilation can impact sleep along with light levels. A person who is accustomed to darkness may find it taxing to sleep in the night.

39
Q

What are other factors that may affect the patient’s sleep?

A

Comfort and the size of the bed

40
Q

This is considered by most experts to be the number one cause of sleeping difficulties.

A

Stress (A person preoccupied with personal problems such as job related pressures, may prod them to have a taxing time to relax efficiently and fall asleep)

41
Q

How is the daily affective wellbeing of the patient or the positive and negative experiences affect the patient?

A

Studies probing into the relationship between the affect and sleep have been declared as static, where they defined affective experiences in terms of overall levels. Higher levels of negative affect and lower levels of positive affect are commonly related to poor sleep.

42
Q

This supported the notion because findings of the study show that positive affect variability in general has significant association with sleep in older adults.

A

Leger et al (2019)

Higher affect variability can be detrimental for the physical and psychological wellbeing. Greater affect variability was related to poorer sleep. Greater positive affect variability was associated with sleeping fewer hours.

43
Q

How does lifestyle on smoking affect sleep?

A

Nicotine has a stimulating effect on the body hence prodding smokers to have difficulty in sleeping. Smokers are also easily aroused and are defined as light sleepers.

44
Q

How does lifestyle on social media use affect sleep?

A

Sleep deprivation has been associated with the use of screens, cellphone, and internet. The use of screens has been shown to delay sleep onset and melatonin secretion. And stimulation of wake systems by interaction with social media may exacerbate the effects.

45
Q

This study that access to social media in teenager’s bedrooms is associated with reduction of sleep, negative effects on daily functioning and mood. This increases with increasing age.

A

Parrola et al (11 years onwards. this recommends the involvement of parents by setting parent-controlled bedtimes)

46
Q

What is the effect of caffeine on sleep?

A

This is the most widely consumed psychoactive alkaline. This is the primary caffeine dietary source of western Europe. They act as stimulants of the central nervous system. Drinking caffeine in the afternoon and the evening may interfere with sleep.

47
Q

What is the effect of alcohol on sleep?

A

People who often drink alcohol are posed to sleep disturbances. REM sleep have worn off. Alcohol tolerant may be unable to sleep well and become irritable.

48
Q

This study shows that men with more alcohol consumptions suffer from poor sleep quality, experience difficulty in maintaining sleep rather than falling asleep, suffer from short term sleep hence prodding them to have re-subjective sleep quality.

A

Park et al (2015)

49
Q

This can be linked with alcohol consumption.

A

Snoring

50
Q

This has been associated with reduced sleep time and broken sleep along with earlier awakening.

A

Weight Gain

51
Q

This has been associated with increased sleep time and less broken sleep.

A

Weight loss

52
Q

This can be found in cheese and milk may induce sleep.

A

Dietary Tryptophan

53
Q

How does exercise affect sleep?

A

Sleep serves as energy conservation, body restoration and thermoregulatory functions; all of which that have guided research the field.

It benefits the general well being but also stresses the body

54
Q

These shows that differences in the exercise protocols from aerobic and anaerobic along with differences in the intensity and duration of the exercise may cause a sleep enhancing effect. It increases a total sleep time and delays REM onset by 10 minutes. Increases the slow wave sleep and reduce REM from 2 to 5 minutes.

A

Driver and Bate in 2000

55
Q

How does sleep disturbances affect sleep?

A

(A) Particular disruptions in sleep physiology can generate musculoskeletal pain, fatigue and mood disturbance.
(B) Impaired sleep may contribute may to impaired mental alertness.
(C) Sleep disturbance may function as a part of a depressive syndrome commonly seen among patients with chronic pain.
(D) Excessive rest can foster avoidance and disengagement from activity.

56
Q

These are conditions that if untreated may generally cause disturbed nighttime sleep in one of three problems.

A

Sleep disorders

57
Q

These are conditions that if untreated may generally cause disturbed nighttime sleep in one of three problems, namely:

A

(1) Insomnia
(2) Abnormal movements from sensations during sleep
(3) Waking up at night or excessive daytime sleepiness or EDS

58
Q

How should the nurse assess sleep problems under the nursing process?

A

(A) Nature of the problem
(1) Sleep problem
(2) Why do you think you’re not getting enough sleep
(3) Describe recent night’s sleep

(B) Signs and symptoms
(1) Difficulty of falling asleep, staying asleep or waking up
(2) Snoring
(3) Headaches

(C) Onset and duration
(1) When did you notice the problem?
(2) What do you do relieve symptoms?
(3) How long has this problem lasted?

(D) Severity
(1) How long does it take for you to fall asleep?
(2) How often during the week?
(3) How many hours of sleep did you get this week?
(4) Usual amount of sleep

(E) Predisposing factors
(1) What do you do just before you get out of bed?
(2) Changes at work or home
(3) How is your mood
(4) Medications or recreational activity
(5) Food consumed, alcohol or caffeinated drinks
(6) Physical fitness
(7) History of sleep problem

59
Q

What should be assessed under the patient’s history as per sleep disorders?

A

(1) Description of sleeping problem
(2) Usual sleep pattern
(3) Physical and psychological illness
(4) Current life events
(5) Emotional and mental status
(6) Bedtime routines
(7) Bedtime environment
(8) Behavior of sleep deprivation

60
Q

What are the different types of nursing diagnosis as per sleep disorders under the nursing process?

A

(1) Anxiety
(2) Ineffective breathing pattern
(3) Acute confusion
(4) Ineffective coping
(5) Insomnia
(6) Fatigue
(7) Disturbed sleeping pattern
(8) Sleep deprivation
(9) Readiness for enhanced sleep

61
Q

How should the nurse perform planning as per sleep disorders under the nursing process?

A

(1) Select nursing intervention that will promote sleep in the home and healthcare setting
(2) Involve sleep partners as needed
(3) Consult with health professionals as needed such as sleep specialists which are considered as the professionals in this field

62
Q

How should the nurse perform implementation for their health promotion as per sleep disorders under the nursing process on their environment?

A

(A) Environmental controls: room temperature, proper ventilation, minimal source of noise, comfortable bed, and proper lighting

63
Q

How should the nurse perform implementation for their health promotion as per sleep disorders under the nursing process on promoting bedtime routines?

A

(1) Regular bedtime and wake up schedule
(2) Quiet and relaxing activities
(3) Relaxation exercises such as deep breathing exercises for 1 to 2 minutes to relieve tension
(3) Guided imagery and praying

64
Q

How should the nurse perform implementation for their health promotion as per sleep disorders under the nursing process on promoting safety?

A

(1) Night light for patients at risk for fall
(2) Beds set to the lowest height
(3) Remove clutter
(4) Placing bell to call family
(5) Place infants on his or her back, remove pillows, stuffed toys to prevent suffocation

65
Q

How should the nurse perform implementation for their health promotion as per sleep disorders under the nursing process on promoting comfort?

A

Wear lose fitting clothes, providing extra blanket and voiding before returning to bed

66
Q

How should the nurse perform implementation for their health promotion as per sleep disorders under the nursing process on establishing periods of rest and sleep?

A

(1) Increasing daytime activity
(2) Afternoon for resting period
(3) Adjust medication schedule for homecare
(4) Regularly void during rest periods

67
Q

How should the nurse perform implementation for their health promotion as per sleep disorders under the nursing process on stress reduction?

A

(1) Encourage patients with disability to sleep to engage relaxing activities
(2) Bedtime snacks; warm milk except with patients with lactose intolerance

68
Q

How should the nurse perform implementation for acute care as per sleep disorders under the nursing process on environmental controls?

A

Closing curtains, dimming lights, noise in the hospital

69
Q

How should the nurse perform implementation for acute care as per sleep disorders under the nursing process on promoting comfort?

A

(1) Keeping bed clean and dry
(2) Comfort measures for pain
(3) Proper positioning

70
Q

How should the nurse perform implementation for acute care as per sleep disorders under the nursing process on establishing period of rest and sleep?

A

(1) Establishing period of rest and sleep
(2) Avoid waking patients for non-essential tasks

71
Q

How should the nurse perform implementation for acute care as per sleep disorders under the nursing process on promoting safety?

A

(1) Monitoring patient’s airway
(2) Teach patient to elevate head of bed or use lateral of prone position to sleep
(3) Use CPAP (continuous positive airway pressure)

72
Q

How should the nurse perform implementation for acute care as per sleep disorders under the nursing process on stress reduction?

A

(1) Providing information to minimize anxiety and uncertainty, talking to patient

73
Q

How should the nurse perform implementation for restorative or continuing care as per sleep disorders under the nursing process on promoting comfort?

A

(1) Providing personal hygiene
(2) Warm bath or shower before bedtime
(3) Positioning
(4) Back or hand massage to aid in muscle relaxation

74
Q

How should the nurse perform implementation for restorative or continuing care as per sleep disorders under the nursing process on controlling physiological disturbances?

A

(1) Positioning for DOB
(2) Small meal several hours before bedtime in a semi sitting position for patients with GERD
(3) Timed medication
(4) Remove or change any irritants

75
Q

This is a neurohormone produced in the brain that helps control circadian rhythms and promote sleep.

A

Melatonin (nutritional supplement taken 2 hours before bedtime)

76
Q

This herbal products is a home care under pharmacological approaches for patients with mild insomnia.

A

Valerian

77
Q

This herbal products is a home care under pharmacological approaches for patients with anxiety.

A

Kava

77
Q

This herbal products is a home care under pharmacological approaches for patients with mild sedative effect.

A

Chamomile

78
Q

What are the different pharmacological approaches in home care for treating sleep disorders?

A

(1) Use of non-prescription sleeping medications is not advisable.
(2) Caution older adults on use of antihistamines which can cause confusion, constipation, urinary retention and risk for falls.
(3) help patient use behavioral and sleep hygiene measures rather than pharmacological

79
Q

These are medications under pharmacological approaches for acute and chronic care that induce sleep.

A

Hypnotics

80
Q

These are medications under pharmacological approaches for acute and chronic care that induce sleep. a calming or soothing effect.

A

Sedatives

81
Q

What are the different types of medications pharmacological approaches for acute and chronic care?

A

(1) CNS stimulants or depressants
(2) Hypnotics
(3) Sedatives
(4) FDA requires all product labels of all sleep medications to contain safety information
(5) Benzodiazepines and benzodiazepine-like drugs are common drugs to treat sleep problems
(6) Consider alternative approaches to promote sleep
(7) Routine assessment of patient response under sleep medication is important

FUNDAMENTALS OF NURSING PRACTICE (13 decks)

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