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Nursing 171 > NURS 171: Week 12: Sleep and Rest > Flashcards

NURS 171: Week 12: Sleep and Rest Flashcards

(51 cards)

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1
Q

Rest

A
  • inactive with mild to no activity
  • relaxation; stress-free
  • leads to feeling refreshed
    ex: reading, listening to music, surfing the internet, praying or meditating, gardening, playing golf
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2
Q

Sleep

A
  • cyclical states/ altered consciousness
  • decreased motor activity/ perception
  • selective response to external stimuli
  • metabolism decreases
    ex: unaware of environment and responds selectively to external stimuli (alarm clock, bright light)
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3
Q

Why Do We Need Sleep?

A

-essential for physical, mental, and spiritual well being
-sleep, rest, and illness are interrelated
-increases mental performance
>improves learning
>helps the storage of long-term memory
-restores energy
-improves ability to cope
-strengthens immune system

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4
Q

How Much Sleep Do We Need?

A
  • older adults: need less (5-7 hrs) plus naps
  • newborns: 16-20
  • adolescents: 8-9
  • young adults: 7-8
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5
Q

Circadian Rhythm

A
  • internal clock affected by light
  • 24-hour-day-night sleep/wake pattern
  • affects overall level of functioning
  • people who work evening and night can suffer significant sleep deprivation until body adjusts to shift
  • changing time zones and hospitalization can lead to disrupted sleep wake cycles
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6
Q

How is Sleep Regulated?

A

-reticular activating system (nerve pathways affecting consciousness)
-stages of sleep
-cycles average of 90 to 120 minutes
>NREM (restful place)
>REM (brain highly active)

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7
Q

What Factors Affect Sleep?

A
  • total amount of sleep
  • how well the person slept
  • whether the needed amounts of NREM and REM were achieved
  • sleep amounts and sleep patterns vary
  • seep quality has both subjective and objective components
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8
Q

Factors Affecting Sleep In Older Adults

A
  • nocturia
  • side effects of medications
  • discomfort or pain
  • partners sleep habits (snoring, restlessness)
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9
Q

Factors Affecting Sleep In Young Adults

A
  • studying all night
  • driven to succeed
  • late work nights
  • stress
  • parents of young children with sleep disturbances
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10
Q

Factors Affecting Sleep

A
  • Lifestyle Factors
  • Illness
  • Environmental Factors
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11
Q

Factors Affecting Sleep: Lifestyle Factors

A

-Physical Activity: exercise more than 2 hours before bedtime
-Food: can promote or interfere with sleep
>saturated fat, L tryptophan, carbohydrates
-Alcohol: go to sleep easier but disrupts REM sleep
-Medications: promotes or interrupts sleep
-Nicotine + Caffeine: stimulants

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12
Q

Saturated Fat Vs Effects on Sleep

A

interferes with sleep

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13
Q

L. tryptophan vs Sleep

A

(milk + cheese)

-may induce sleep

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14
Q

Carbohydrates Vs Sleep

A

seem to promote relaxation

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15
Q

Factors Affecting Sleep: Illness

A
  • increases need for sleep + rest

- associated with mental + physical distress that disturb sleep

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16
Q

Factors Affecting Sleep: Environmental Factors

A

promote or inhibit sleep

  • temperature + humidity
  • noise + light
  • odors or allergies
  • comfort of bedding
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17
Q

Common Sleep Disorders

A

-Insomnia
-Circadian Disorders
-Restless Leg Syndrome
Dyssomnias:
>hypersomnia
>sleep apnea
Parasomnias:
>sleepwalking, sleep-talking, bruxism, night terrors, REM sleep behavior disturbances, Enuresis (bedwetting)

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18
Q

Insomnia

A

inability to fall or remain asleep or go back to sleep

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19
Q

Insomnia Treatment

A

a combination of behavioral and pharmacological therapy may be effective
-some sleep aids are habit forming

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20
Q

Circadian Disorders

A

abnormality in sleep/wake times

e.g. jet lag, working night shift, rotating shifts

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21
Q

S + S of Circadian Disorders

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A
  • decreased ability to perform psycho-motor tasks

- short sleep episodes person is not aware of (dozing off)

22
Q

Treatment of Circadian Disorders

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A

need several days to adjust sleep wake schedule

23
Q

Restless Leg Syndrome

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A

disorder of the CNS with overwhelming urge to move the legs while resting or before sleep onset

24
Q

S + S of Restless Leg Syndrome

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A

-unpleasant creeping, crawling, itching, or tingling sensation in the legs

25
Treatment for Restless Leg Syndrome
- relieved only by moving the legs - may include neuroleptic agents and medication used to treat parkinsons disease - avoid caffeine + other stimulants - walking - massage - stretching - heat or cold compresses - medication vibration - acupressure
26
Dyssomnias
trouble falling or staying asleep - hypersomnia - sleep apnea
27
Dyssomnia: Hypersomnia
excessive sleeping (especially during daytime) - sleep-related or disease-related - can be related to depression - can be related to sleep apnea or narcolepsy or disorders of CNS, kidney, liver or metabolic disorders (diabetic acidosis and hypothyroidism)
28
Dyssomnia: Sleep Apnea
- snoring is the biggest sign of obstructive sleep apnea - soft tissue of pharynx and soft palate collapse + obstruct airway for at least 10 seconds during sleep cycles - oxygen level in blood drops and carbon dioxide level rises causing person to wake up - complain of fatigue and morning headache - diagnosed with sleep study
29
Narcolepsy
genetic defect of the CNS in which REM sleep can not be controlled - chronic disorder caused by the brains ineffectiveness in regulating sleep-wake cycles normally - sudden, uncontrollable episodes of sleep during the day
30
S + S of Narcolepsy
- sleepiness - slurred speech - slackening of facial muscles - feeling of impending weakness of knees - paralysis + hallucinations - performance is impaired - awaken feeling refreshed - do not tolerate irregular sleep-wake patterns such as shift work
31
Treatment for Narcolepsy
-CNS stimulants such as methylphenidate (Ritalin)
32
Parasomnias
common sleep disorders that happen during sleep - sleepwalking - sleep-talking - bruxism - night terrors - REM sleep behavior disturbances - Enuresis (bedwetting)
33
Parasomnia: Sleepwalking
- In NREM sleep 1 to 2 hours after person falls asleep - if dangerous, given medication to suppress the deepest stage III NREM sleep - can be triggered by stress, fatigue, and some drugs
34
Parasomnia: Sleep-talking
in NREM sleep just before REM
35
Parasomnia: Bruxism
grinding and clenching of the teeth in NREM sleep | -can erode tooth enamel and loosen the teeth
36
Parasomnia: Night Terrors
sudden arousal (usually children) with activity, hallucinations, and expression of terror with no memory of event
37
Parasomnias: REM Sleep Behavior Disturbances
violently acts out dream
38
Parasomnias: Enuresis
(bedwetting) - most during NREM sleep early in night - most outgrow, patients
39
Disorders that are Provoked by Sleep
- Coronary Artery Disease - Asthma - COPD - Diabetes - Gastric + Intestinal Ulcers - Peptic Ulcers
40
Disorder Provoked by Sleep: Coronary Artery Disease
- during REM sleep | - dreams may increase heart rate, and provoke angina and ECG changes
41
Disorder Provoked by Sleep: Asthma
- may experience bronchospasm during REM sleep | - asthma attacks at night as esophageal sphincter relaxes and reflux results
42
Disorder Provoked by Sleep: COPD
-experience lower oxygen tension and increased carbon dioxide retention during sleep, especially during REM sleep
43
Disorder Provoked by Sleep: Diabetes
blood glucose levels vary during the night
44
Disorder Provoked by Sleep: Gastric and Intestinal Ulcers
during REM sleep people with duodenal ulcers secrete up to 20 times more gastric acid
45
Disorders Provoked by Sleep: Peptic Ulcers
also contributes to increased acid producing nocturnal epigastric pain and sleep loss
46
Planning Interventions/ Implementation
- cluster/schedule nursing care to avoid interrupting sleep - create a comfortable/ restful environment - promote comfort/ relaxation - support bedtime rituals/ routine - offer foods that promote sleep - teach about sleep hygiene - administer/ complete client teaching about sleep-inducing medications - "iCare" - "quiet heals" (Nsg Units have certain quiet times of the day)
47
Prescription Medications
- Nonbenzodiazepines - Benzodiazepines - Barbiturates
48
Nonbenzodiazepines
- sedative/ hypnotic - short half life, eliminated from the body quickly and do not cause "hangover" (daytime sleepiness) - Ambien, Sonata, Lunesta
49
Benzodiazepines
- sedative/ hypnotic - both long-acting and short-acting drugs - long-acting medications linger in the body and potentially cause daytime drowsiness - Valium, Xanax, Ativan
50
Barbiturates
- sedative/ hypnotic - anticonvulsants - rarely prescribed for insomnia because of risk of addiction, abuse and overdose - Nembutal, Seconal
51
Non Prescription OTC Sleep Medications
sleep medications usually contain an antihistamine, which may induce drowsiness that lasts into the next day - Benadryl, any "pm" meds - Melatonin, Herbal sleep aids

Nursing 171 (38 decks)

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