Chapter 38 Rest and Sleep PDF

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Chapter 38 Rest and Sleep
Buchanan...

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Chapter 38 Rest and Sleep 1. A nurse in a provider’s office is caring for a client who states that, for the past week, “I have felt tired during the day and cannot sleep at night.” Which of the following responses should the nurse ask when collecting data about the client’s difficulty sleeping? (Select all that apply) © Have your working hours changed recently? © Do you drink coffee, tea, or other caffeinated drinks? If so, how many cups per day? © Has anyone ever told you that you seem to stop breathing for a few seconds while you are asleep? © Tell me about any personal stress you are experiencing 2. A nurse is talking w/ a client about ways to help sleep and rest. Which of the following recommendations should the nurse give to the client to promote sleep and rest? (Select all that apply) © Practice muscle relaxation techniques © Exercise each morning © Alter the sleep environment for comfort © Limit fluid intake at least 2 hr. before bedtime 3. A nurse is caring for a client who has been following the facility’s routine and bathing in the morning. However, at home, the client always takes a warm bath just before bedtime. Now the client is having difficulty sleeping at night. Which of the following actions should the nurse take first? (Select all that apply) © Allow the client to take a bath in the evening 4. A nurse is preparing a presentation at a local community center about hygiene. When explaining rapid eye movement (REM) sleep, which of the following characteristics should the nurse include? (Select all that apply.) © REM sleep provides cognitive restoration

© It is difficult to awaken a person in REM sleep © Vivid dreams are common during REM sleep 5. A nurse is instructing a client who has narcolepsy about measures that might help with self-management. Which of the following statements should the nurse identify as an indication that the client understands the instructions? © I’ll take a short nap whenever I feel a little sleepy ----------------------------------------------------------------------Notes: The sleep cycle consists of 3 stages of NREM and a period of REM: (REM sleep accounts for 20% to 25% of sleep time) Stage 1 NREM (Non-rapid eye movement) Sleep o Very light sleep o Only a few minutes long o Muscle relaxation o Loss of awareness of surroundings o Vital signs & metabolism beginning to decrease o Awakens easily o Feels relaxed and drowsy Stage 2 NREM (Non-rapid eye movement) Sleep o Deeper sleep o 10-20 min long o Vital signs and metabolism continuing to slow o Requires slightly more stimulation to awaken o Increased relaxation Stage 3 NREM (Non-rapid eye movement) Sleep o Slow wave sleep or delta sleep o Vital signs decreasing o More difficult to awaken o Psychological rest and restoration o Reduced sympathetic activity REM (Rapid Eye Movement) Sleep o Vivid dreaming o About 90 mins after falling asleep, recurring every 90 mins o Longer with each sleep cycle

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Average length 20 min Varying vital signs Very difficult to awaken Cognitive restoration

Terminology Sleep apnea – more than 5 breathing cessations lasting longer than 10 seconds per hour during sleep, resulting in decreased arterial oxygen saturation levels o Sleep apnea can be a single disorder or a mixture of the following: o Central: CNS dysfunction in the respiratory control center of the brain that fails to trigger breathing during sleep o Obstructive: structures in the mouth & throat relax during sleep & occlude the upper airway o Narcolepsy – sudden attacks of sleep that are often uncontrollable o Hypersomnolence disorder – excessive daytime sleepiness lasting at least 3 months o Impairs social & vocational activities o Increased risk for accident or injury related to sleepiness...