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Sleep Flashcards

1
Q

What is the stage 1 sleep phase?

A

Falling asleep

lightest sleep

Only lasts a few minutes

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2
Q

What is the stage 2 sleep phage?

A

Heart rate slows

Body temperature drops

  • Non-REM
  • Relaxation begins
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3
Q

What is the stage 3 sleep phase? 5

A

Deepest sleep

  • Non-REM
  • Muscles, and tissue repair
  • Immune system strengthens
  • Vital sings are lower than waking hours
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4
Q

Rapid eye movement

A

The body is paralyzed and dreams begin

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5
Q

What is the stage 4 sleep phase? 4

A

Dreams begin

  • REM sleep
  • Body is paralyzed
  • BP, HR and RP are increased/rapid fluctuation
  • Very difficult to wake up
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6
Q

Sleep disorders 5

A

Insomnia
Apnea
Polysomnography
Narcolepsy
Hypersomnia

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7
Q

Sensory overload

A

In the hospital setting, the client’s sleep is interrupted multiple times due to the need for complex interactions and procedures.

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8
Q

Insomnia? 3

A
  • Difficulty falling asleep or staying asleep
  • Frequent awakenings
  • Feeling tired when waking

Can affect physical, mental, emotion

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9
Q

Sleep apnea? 2types

A

Lack of airflow through the nose or mouth for 10 seconds

to 1-2 minutes

Obstructive apnea(OSA) the most common

-Obesity, HTN, smoking, age, heart failure

Central apnea(CSA) impairment of brainstem

-Brainstem injury, stroke, obesity

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10
Q

Narcolepsy? 4

A
  • Sudden sleepiness
  • Sudden periods of sleep
  • Difficulty staying awake
  • Overwhelming wave of sleepiness at an inappropriate time

They can go into REM sleep within 15 minutes

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11
Q

Hypersomnia?

A

Excessive daytime fatigue without improvement after more sleep

Associated poor memory,depression.

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12
Q

Function of sleep 3

A
  1. Memory Consolidation/ Brain development
  2. Preparation for wakefulness
  3. Restores biological processes/repair and renewal
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13
Q

What are some BAD habits for sleep? 6

A
  1. Caffeine
  2. Stress
  3. Heavy food
  4. Heavy training at night time
  5. Alcohol
  6. Blue light/devices
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14
Q

What are GOOD habits for sleep? 5

A
  1. Maintain sleep routine( get up at the same time)
  2. Excise in the daytime
  3. Cool and darkroom
  4. Relaxing bath
  5. Comfortable sleep aids
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15
Q

Sleep pattern history, routine, has it changed?

Why does it important to ask?

A
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16
Q

Effect on patient functioning and quality of life.

Why does it important to assess?

A
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17
Q

Emotional and mental status

How is it related to sleep disorders?

A

-A lack of sleep leads to moody, emotional, grouchy

Depression, and anxiety (Chronic)

Good sleep cause increased mental perfomance

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18
Q

Sleep hygiene assessment 6

A
  1. Consider medication use
  2. Loss of routine
  3. Emotional and mental stress
  4. Environmental stimulation
  5. Timing of exercise
  6. Diet and substance use
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19
Q

Consider medication use

Why is it important related to sleep?

A

-Sleep aid medication maybe don’t help pt sleep

Or maybe too early to take or too late to take

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20
Q

Environment stimulation

How is it affect healthy sleep?

A
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21
Q

Timing of exercise

How is it affect healthy sleep?

A
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22
Q

a) Polysomnogram?

b )Actigraphy?

A

a) Measures eye movement(EOG)

Muscle tone changes(EMG)

Neuroglial electrical activity(EEG)

b) Measures sleep time(EOG)

Efficiency

Number and duration of awakenings

Levels of activity and rest for prolonged periods of time

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23
Q

What is the nursing diagnoses of sleep disorders? 4

A
  1. Impaired sleep
  2. Fatigue
  3. Impaired alertness
  4. Sleep deprivation
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24
Q

how does sleep distraction affect patient?

A
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25
How does sleep distraction affect the health care workers?
**Too long or repeated shifts reduce the opportunity for sleep Shorten recovery time in the healthcare workers** - Can result in cognitive impairment - Impair performance/decision making, memory planning - Lead accidents both in and off the job
26
Central sleep apnea causes what? 5
- Opioid overdoes - Congestive heart failure - Reduction of the brain's transmission - Brainstorm injury - Stroke
27
What is the first-line sleep aid medication for old pt?
Controlled release melatonin - Cost-effective - Non-habit forming - Few adverse effects
28
Pt needs to wake up for the oral medication, but the pt was in stage 3 sleep. What to expect?
The pt experience mental cloudiness for 30 to 60 min. -stage 3 is the deepest stage of sleep
29
The pt who works overnight shifts increased the risk of what disease? 3
- Diabetes mellitus - Obesity - Cardiovascular disease
30
Why do shift workers often experience obesity? 3
- Poor diet - Lack of exercise - Hormone imbalance
31
OTC sleep aid medications every evening can cause what? 5
- Urinary retention - Daytime drowsiness - Dry mouth - Visual disturbances - Constipation
32
Excessive smartphone use risk of what?
Depression and poor sleep
33
An old adult wakes up frequently during the night. This is because they tend to spend more at what stage of sleep?
**Stage 2** contribute to them to frequent awakenings -environmental factors, such as noise
34
Nursing diagnoses process
Make sure the evidence I have is going to meet the practice for the diagnoses See causes of cluster data What I can apply to the whole cluster Only then pick diagnoses for the last
35
A pt comes to the clinic with concerns of feeling constantly tired. What assessment is the best for this pt's sleep concern?
Describe for me a recent night's sleep. How is this similar or different from your usual sleep? Do you have a hard time falling asleep or staying asleep? This is NOT GOOD! because **YES or NO** question.
36
The nurse assess the pt who had sleep difficulties since losing her job. What should the nurse include for the assessment? 5
Sleep patterns before and after the loss Meaning of the sleep loss Medications used for sleep How she feels during the day Past medical history of acute and chronic pain
37
Why does the promote bedtime routine important?
Tell body to time to go to sleep brush teeth, get water, read a story, light out etc
38
When planning care to sleep deprivation,who should involved the pt care plan?
Sleep partner which sleeps next to the p -Whoever share the room with the pt
39
What example interventions for impaired sleep? 5
- Sleep hygiene education - Environment control - Promote bedtime routine - Daytime physical activity - Stress reduce technique
40
What we can do with interventions at the hospital setting for the pt has impaired sleep?
- Environmental controls/close door, dim lights - Promote comfort and manage pain - Minimize sleep interruptions/cluster nursing care
41
For the medical diagnostics, what tool do Dr use?
Polysomnogram and Actigraph
42
What is the difference between a polysomnogram and an actigraph?
Poly looks at SMLL details Acti looks at the BIG pictures
43
Symtoms of sleep apenea?
- Daytime sleepiness - Fatigue - Irritability - Depression - Snoring
44
What is the benefit of sleep? 6
- Increases mental performance - Restores energy - Strengthens the immune system - Reduce stress - Maintain hormonal balance - Helps the storage of long-term memory
45
A nurse observes some involuntary muscle jerking in a sleeping PT. which stage of sleep?
Stage 1 ## Footnote In the other stages, the muscles proceed from a relaxed state to large muscle immobility
46
A nurse is discussing with an older female patient the factors that affect sleep. What fact does the nurse teach her?
Aging decreases the amount of REM sleep
47
What disease would be considered at a higher risk for having sleep disturbances?
- Uncontrolled hypothyroidism/decreased NREM - Coronary artery disease/pain - Gastroesophageal reflux (GERD)/awaken at night with heartburn pain
48
What questions to ask a patient regarding sleep?
What time do you go to bed? What time do you usually wake up? How long does it take you to fall asleep? Do you awaken during the night? How long have you had this sleep pattern? Do you feel you get enough sleep (quantity)? Also check mental states
49
Describe for me a recent night's sleep. How is this similar or different from your usual sleep? This is assesment stage, so pick something indicate about asses. Do you have a hard time falling asleeo or staying asleeo? is not correct. Because this is
50
What is a polysomnogram?
Measures eye movements Muscle tone changes Neurological electrical activity **Small details**
51
What is an actigraphy?
Measure sleep time Number of the duration of awakenings levels of activity Rest periods **Looks at the BIG pastures**
52
What is the difference between sleep and rest?
Rest is relaxed physically and mentally while alert and awake Sleep is reduced consciousness
53
What happens in relation to body and brain during NREM? active body quiet brain
Active body quiet brain
54
When the cyclic sleep repeats, what happens?
REM increases
55
What happens in relation to body and brain during REM? active brain quiet body
Active brain quiet body
56
Less REM means what? Less memory info, processing and less storage
Less memory info, processing and less storage
57
How does menopause affect sleep? less estrogen means less sleep
Less estrogen means less sleep
58
**Newborn babies' sleeping pattern**
10-18 hours 50%REM 50%NonREM Skips stage 1-4 Irregular breathing/brief apnea
59
Infant sleep pattern
Take a several naps 8-10 hours total 30%REM
60
school-aged kid sleep pattern
less than 7years Sleep 12 hours of sleep Encourage or do a quiet activity before bed Fear death and nightmares occur 7 years and more Often resist sleep(independent)
61
How many hours do adolescents sleep? 9-10 hours of sleep with nocturnal emissions, late sleep cycles and daytime sleepiness
9-10 hours of sleep with nocturnal emissions, late sleep cycles and daytime sleepiness
62
**Elderly sleep pattern**
Total 6 hours sleep, 25% REM Stage 3 and 4 decreased Awake often at night Tend to nap increase (because awaken during the night)
63
Toddler sleep pattern
Take some naps total 12 hours through the night REM decrease
64
Young adult sleep pattern mid 20s
6-8.5 hours about 20% REM The stress of job, family and social relationships often causes insomnia
65
Middle adult sleep pattern 40-65
Decrease total time of sleep REM begins fall
66
A pt is diagnosed with narcolepsy. The nurse's primary intervention should address the pt is 1: Inability to provide seld=care 2: Altered thought processes 3: Excessive fatigue 4: Risk of injury
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