Sleep/Rest Objectives

Question 1

The nurse is preparing to teach a client about the important of rest and sleep. Which statement made by the client would indicate the need for further teaching?

The client verbalizes that circadian rhythms do indeed influence sleep.

The client suggests that their Reticular Activating System is responsible for maintaining restfulness.

The client verbalizes that they may be less likely to develop an infection if they sleep less than 5 hours per day.

The client suggests they it may be easier to gain weight if they do not get enough regular sleep.

Answer 1

ANSWER: C
When adequate sleep is not maintained the bodies ability to maintain glucose is lessened, therefore responds with insulin resistance. This leads to reduced energy expenditure, all of which can lead to obesity and type 2 diabetes.

All of the other options suggest adequate information.

Question 2

Reticular Activating System (RAS) are _____ . System includes which part of brain _________ and is responsible for

Answer 2

collection of nerve cell bodies within the brainstem,

medulaponsmidbrainhypothalamus

maintaining wakefulness

Question 3

Bulbar Synchronizing Region (BSR)

release ___________. These are can cause either _______ or inhibition.

Answer 3

neurotransmitters

excitation

Question 4

Which neurotransmitters

does BSR release?

Answer 4

Excitation 
Norepinephrine
Acetylcholine
Dopamine
Serotonin
Histamine

Inhibition
GABA

Question 5

What is a biorhythm based on the day–night pattern in a 24-hour cycle

Answer 5

circadian rhythm

Question 6

Circadium rhythm is regulated by_____ that respond to

Answer 6

cells in hypothalamus

respond to light

Question 7

is generally the restful phase of sleep in which physiological function is slow.

Answer 7

NREM

Question 8

During this phase of sleep, muscles relax; body temperature lowers; and heart rate, respirations, and blood pressure decrease.

Answer 8

NREM

Question 9

The type of sleep is sleep is essential for mental and emotional restoration

Answer 9

REM

Question 10

this gland secretes melatonin

Answer 10

pineal gland

Question 11

REM sleep recurs about every ___ min and lasts ___ to ___ min

Answer 11

90

5-30

Question 12

Which stage constitutes 75 - 80% of sleep

Answer 12

NREM

Question 13

What stage of NREM is

Answer 13

This stage composes about 10% of sleep
(10% of 8 hours = 48 minutes total)
Person reaches greatest depth of sleep – Delta Sleep
Arousal is very difficult
Pulse/RR drops 20 -30% below waking hours rates.
B/P decreases
Metabolism and body temp decreases
If people are awakened during this stage, they do not adjust immediately, feel groggy & disoriented.
Children experience – bedwetting or sleep walking (somnambulism).

Question 14

What stage sees

Eyes dart back/forth
Twitching of small muscles (face)
Immobile large muscles
Respirations irregular/apnea
Pulse rapid/irregular
B/P increases or fluctuates
Metabolism and body temp increase
Gastric secretions increase

Answer 14

REM

Question 15

The nurse is performing parent teaching to the parent of a client recently diagnosed with somnambulism. The nurse knows that teaching has occurred when the parent verbalizes the following: Select all that apply.

A complete sleep cycle is 90-100 minutes.

It may be harder for my child to wake up when she is in stage 4 of sleep.

Muscles in the face are likely to twitch during REM sleep.

If my child were to sleepwalk, it will most likely occur during NREM sleep stage 3.

Answer 15

ALL
complete sleep cycle is 90-100 minutes.

It may be harder for my child to wake up when she is in stage 4 of sleep.

Muscles in the face are likely to twitch during REM sleep.

If my child were to sleepwalk, it will most likely occur during NREM sleep stage 3.

Question 16

Age where
Sleep pattern- sleep through the night by 6 months
10-12 hours night/ 2-3 daytime naps

Answer 16

Infants

Question 17

Age where

Sleep patterns -12 hours per night decreasing to 8-10 as they reach preschool age

Answer 17

Toddler

Question 18

True or False:Although sleep may become more difficult, the need to sleep does not change with age

Answer 18

True

Question 19

Seen in older patients with Alzheimer’s disease
Not a sleep disorder directly, it refers to a pattern of symptoms; e.g., agitation, anxiety, aggression, and sometimes delusions
Occurs in the late afternoon
Can last through the night, further disrupting sleep

Answer 19

Sundowning Syndrome

Question 20

More spontaneous awakenings occur during this stage than any other.

Answer 20

REM

Question 21

Loss of _______sleep impairs memory and learning

Answer 21

REM

Question 22

What is REM rebound

Answer 22

When A person who is deprived of REM sleep for several nights —that is, spend a greater amount of time in REM sleep on successive nights, keeping the total amount of REM sleep constant over time.

Question 23

what natural hormone declines in latter decades of life

Answer 23

melatonin

Question 24

Two groups of sleep disorders

Answer 24

Dyssomnias and Parasomnias

Question 25

Disorders including: insomnia, sleep–wake schedule (circadian) disorders, sleep apnea, restless legs syndrome, hypersomnia, and narcolepsy.

Answer 25

Dyssomnias

Question 26

what is parasomnia

Answer 26

Patterns of waking behavior that appear during sleep (sleepwalking)

Question 27

What is the predominant complaint of dissatisfaction with sleep quantity, associated with the inability to fall asleep, remain asleep, or go back to sleep.

Answer 27

Insomnia

Question 28

Etiologies of Insomnia

Answer 28

medsor inadequate sleep hygiene (e.g., watching TV in bed, sleeping with smartphone nearby, drinking caffeine-containing beverages before bedtime).

Question 29

a disorder of the central nervous system characterized by an uncontrollable movement of the legs while resting or before sleep onset.

Answer 29

Restless Legs Syndrome (RLS)

Question 30

unpleasant creeping, crawling, itching, tingling or burning sensations in the legs is relieved only by moving and stretching, which prevents the person from relaxing and falling asleep.

Answer 30

Restless Legs Syndrome (RLS)

Question 31

People with RLS should avoid

Answer 31

stimulants (e.g., caffeine)

Question 32

not actually a sleep disorder but rather, in NANDA-I terms, a human response to prolonged sleep disturbances (e.g., insomnia and parasomnias), involving NREM or REM deprivation, or both.

Answer 32

Sleep Deprivation

Question 33

Illness and hospital care are common causes of

Answer 33

Sleep Deprivation

Question 34

excessive sleeping, especially in the daytime.

Answer 34

Hypersomnia

Question 35

Common causes of hypersomnia

Answer 35

sleep apnea, narcolepsy, and snoring; disorders of the central nervous system, kidney, or liver; and metabolic disorders (e.g., diabetic acidosis and hypothyroidism). Hypersomnia can also be a symptom of depression.

Question 36

a periodic interruption in breathing during sleep

Answer 36

Sleep apnea

Question 37

Sleep disorder that may result in cardiac dysrhythmias (irregularities) and increases in pulse and blood pressure. Many people with sleep apnea complain of unrefreshed sleep, fatigue and morning headache, and easily falling asleep during sedentary activity;

Answer 37

Sleep apnea

Question 38

diagnosed clinically by reports of at least five witnessed breathing interruptions or awakenings due to gasping or choking events per hour

Answer 38

Obstructive Sleep Apnea OSA

Question 39

treatment for OSA

Answer 39

surgery to remove obstruction within the airway. Other treatments include the following: Applying continuous positive airway pressure or bilevel positive airway pressure treatment. This is a device that delivers oxygen using forced air pressure and keeps the airways open. Oral appliance therapy to pull the tongue forward or adjust the space in the pharyngeal space. Advising the patient to avoid alcohol and smoking and lose excess weight

Question 40

What is happening:the soft tissue of the pharynx and soft palate or other structures in the throat area (deviated nasal septum, enlarged tonsils) collapse and obstruct the airway during sleep, but the person continues to try to breathe

Answer 40

OSA

Question 41

a chronic disorder caused by the brain’s inability to regulate sleep–wake cycles normally. The distinction between being asleep and being awake are blurred.

Answer 41

Narcolepsy

Question 42

may be caused by rapid time-zone changes (jet lag), shift work, or a change in total sleep time from day to day.

Answer 42

Sleep–Wake Schedule (Circadian) Disorders

Question 43

occur when a disease causes alterations in sleep stages or in quantity and quality of sleep.

Answer 43

Secondary Sleep Disorders

Question 44

Common secondary sleep disorders

Answer 44

Depression Hyperthyroidism - Increase in metabolic rate - can't fall asleep Hypothyroidism - Decrease in REM sleep Pain

Question 45

Risk factors for sleep apnea

Answer 45

Weight –Neck size –Being male

Question 46

– Lack of airflow through the nose and mouth for periods of 10 seconds or longer during sleep

Answer 46

Sleep apnea

Question 47

causes of sleep apnea

Answer 47

``` Changes in airway during sleep Overweight/obesity Shape of head and neck Aging process Air flow, oxygen levels ```

Question 48

one of the most common sleep studies performed in a sleep lab, records brain wave activity, eye movement, oxygen and carbon dioxide levels, vital signs, and body movements during the sleep phases. EEG, EMG and EOG

Answer 48

Polysomnography

Question 49

Diagnosis: Use for patients who have a disruption in the amount of quality of sleep to the extent that it impairs functioning.

Answer 49

Insomnia

Question 50

Diagnosis: Use as the nursing diagnosis when the patient’s amount, consistency, or quality of sleep is decreased over prolonged periods of time.

Answer 50

Sleep Deprivation

Question 51

Diagnosis: Use as the diagnosis when assessment data point to a time-limited sleep problem due to external factors (e.g., inability to sleep in the unfamiliar hospital environment).

Answer 51

Disturbed Sleep Pattern

Question 52

Use this diagnosis when a client without a sleep disorder desires improved quality or duration of sleep.

Answer 52

Readiness for Enhanced Sleep

Question 53

a term referring to interventions used to promote sleep.

Answer 53

Sleep hygiene

Question 54

These medicines have a short half-life; they are eliminated from the body quickly and do not cause daytime sleepiness. Examples are

Answer 54

Nonbenzodiazepines zolpidem tartrate (Ambian) and zaleplon (sonata)

Question 55

is the first-line treatment for insomnia.

Answer 55

``` Benzodiazepines class of: sedative/hypnotics ```