rest and sleep Flashcards

1
Q

tell me a bit about sleep

A

it is a basic necessity of life and is as important as air, food, water.

Individuals are sleeping less, chronic sleep loss may have adverse outcomes for health and well-being.

Insufficient sleep alters mood and decreases the
ability to concentrate, make decisions, and participate in daily activities.

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2
Q

explain physiology of sleep

A

*A cyclical physiological and behavioral process that alternates with longer periods of wakefulness

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3
Q

the physiology of sleep is controlled by three distinct processes, what are they?

A

1) Ultradian process: non–rapid eye movement (NREM) and rapid eye movement (REM)

2) Homeostatic process (process S): sleep–wake cycle

3) Circadian process (process C): maintaining wakefulness

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4
Q

explain circadian rhythms

A
  • 24-hour circadian rhythm
  • Factors include light, temperature, social activities, and work routines
  • Biological clock
    *Synchronizes sleep–wake cycles (e.g., bedtime)
    *Affects individual’s optimal time of day
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5
Q

do hospital routines interrupt sleep?

A

yes

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6
Q

name the stages of sleep

A
  • awake
  • rem sleep
  • nrem sleep
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7
Q

explain sleep regulation

A

Sleep is regulated by a sequence of physiological states integrated by central
nervous system activity (e.g., hypothalamus, anterior pituitary)

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8
Q

what does reticular activation system (RAS) affect

A

wakefulness and sleep–wake
transitions.

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9
Q

what does bulbar synchronizing region cause

A

sleep

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10
Q

name some benefits of sleep

A

Sleep is restorative => necessary for health
* During sleep (NREM), biological functions slow down = e.g. HR, RR, BP, muscle tone, urine production, hormone secretion => all
decrease

  • Preserves cardiac function
  • our heart rate (HR) slows down→ beating 10-26 times fewer each minute
  • There is evidence that sleep improves immune function and ability to
    fight disease
  • Cell and tissue repair
  • Brain filters stored information
    about the day’s activities
  • Without sleep, we become irritable, anxious and stressed
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11
Q

draw the stages of sleep

A
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12
Q

name the stages of sleep

A

Stage 1: Non–rapid eye movement = lightest level of sleep (2–5% of adult sleep time)
* Stage 2: Non–rapid eye movement = sound sleep (45–55% of adult sleep time)
* Stage 3: Non–rapid eye movement = deepest sleep (10% of adult sleep time)
*Rapid eye movement sleep= dreams (25% of adult sleep time)

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13
Q

explain sleep cycle

A

Presleep period (10–30 min)

  • Four to five complete cycles (stages 1, 2, 3 NREM and REM) each lasting 90–120 minutes/cycle in a night
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14
Q

true or false Newborns and children spend more time in stage 3 NREM sleep

A

true

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15
Q

when do dreams occur

A

while we sleep

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16
Q

explain dreams

A
  • A mental activity that occurs while individuals are asleep
  • Occurs mostly during REM sleep but can also occur in NREM sleep
  • Important for learning, memory, and adaptation to stress
17
Q

explain the sleep requirements through the lifespan

A

Newborns (neonates)
* sleep cycle is strongly determined by hunger
* sleep ~16 hours per day

  • Infants (3-12 months old) to Toddler (1-3 years old)
  • cycle follows the day-night schedule more closely
  • sleep ~ 10-12 hours per day with several daytime naps (12-14
    hours total) need for naps decrease with age.
  • Pre School aged child (3-5years old)= ~13 hours of sleep per day, with need for naps decreasing
  • School aged child (5-12 years old) = require ~ 9-10 hours of sleep per night
  • Adolescents (12 and up)=> varies (shorter during the school week) “sleep debt”
  • Young adults= most adults average 6-8.5 hours per night
  • Middle aged to Older adults =changes in sleep patterns occur-decline in total number of hours
18
Q

explain sleep requirements in the older adult

A

Approximately 50% of older adults report
difficulty with sleep
* Increased frequency of spontaneous awaking
* Increased frequency of daytime napping

  • The elderly may be in bed longer but sleep
    less
  • Women are often affected due to hormonal
    changes (menopause)
19
Q

name some sleep disorders

A

*Insomnias
*Circadian rhythm sleep disorders
* Sleep related breathing disorders
*Excessive sleepiness
* Parasomnias
* Sleep related movement disorders

20
Q

name some factors affecting sleep (physical illness)

A

*Illness, disease, and other physical disorders can affect sleep
* Pain
* Anxiety and depression
* Respiratory disease
* Cardiovascular disease
* Musculoskeletal (pain)
* Nocturia

21
Q

name factors affecting sleep

A

*Drugs and substances
* Hypnotics, diuretics, antidepressants, alcohol, caffeine, narcotics,
-blockers, benzodiazepines, anticonvulsants, anti-parkinsonians

*Lifestyle
* Work schedule (shift work), social activities, routines

*Usual sleep pattern
* May be disrupted by social activity or work schedule, travel (e.g., jetlag)

*Emotional stress
* Worries, physical health, death, losses

*Environment
* Noise, routines

*Exercise and fatigue
* Restful sleep enabled by moderate exercise and fatigue

  • Food and caloric intake
  • Time of day, caffeine, nicotine, alcohol, spicy foods
22
Q

explain nursing assessment

A

1)The client is usually the best source of information

2) sleep history= quantity and quality of daily rest and sleep

3)Usual sleep pattern
* Description of sleeping problems
* Signs of sleep deprivation

23
Q

questions u could ask them

A
  • Ask the client about the number of hours of sleep per night
  • Number of daily rest periods throughout the day
  • Ask the client about the quality of sleep per night; hours of
    continuous sleep
  • Has there been a recent change in sleep habit?
    daily rest and sleep
    *Does the client experience restlessness during the night?
    *Number of arousals during the night?
    *What time does the client wake up?
    *Does the client experience sleepiness during the day?
    *Number of naps during the day and for how long?
    *Refer to sleep log
24
Q

questions for sleeping problems

A

Do you have difficulty falling asleep?
* When did you first notice have problems sleeping?
* Do you snore or have you been told you snore?
* Do you feel excessively tired or sleepy during the day?

25
signs of sleep deprivation
Irritability * Inability to concentrate * Forgetfulness * Confusion * Frequent yawning * Increased sensitivity to pain * Agitation
26
name factors that can affect sleep
*Lifestyle and current life events *Bedtime routines *Environment e.g. temperature, the hospital environment *Physical stress; e.g. illness, pain *Developmental stages; e.g. rest and sleep requirements change with age *Psychological condition; anxiety
27
promoting good sleep hygiene
*Daily exercise *Try to keep routines similar on weekdays and weekends *Avoid snacking, studying , TV watching in bedroom area *If you cannot fall asleep in 30 minutes get up and do a quiet activity *Limit consumption of caffeine and ETOH *Is environment noisy or too bright *Avoid eating heavy meals prior to bedtime (up to 3hours before bedtime)
28
nursing interventions
* Environmental Controls (most difficult in the hospital environment)-we often do not control the room temp in a pts room * Promoting bedtime routines * Promoting safety * Promoting comfort * Establishing periods of rest and sleep * Stress reduction * Heavy bedtime snacks to be avoided, but it is ok to have a light snack * Pharmacological approaches- sleep aids
29
interventions for the HOSPITALIZED client
Control the environment * volume control on pumps and monitors- keep low * noise level at the nursing station-be aware * limiting visitors during rest periods * group nursing tasks => avoid non essential tasks during rest periods Promote comfort: * positioning the client to promote comfort; maximize use of pillows * extra blanket * void before sleep * back rub Promote safety: *safety re: falls *careful monitoring of clients under the use of anesthetics and opioids=> these medications put clients at risk for sleep apnea and airway obstruction Pharmacological approaches to aid sleep: *appropriate use of hypnotics, sedatives, and benzodiazepines => for selective situations Pharmacological approaches for pain