Chapter 38: Promoting Sleep and Rest

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Questions and Answers

What can be done to promote rest and sleep?

Using electronics before bedtime

Requesting a prescription for a sleep medication from the provider

Following an exercise routine regularly, at least 2 hours prior to bedtime (correct)

Napping during the day

Which of the following is an example of a least restrictive intervention to promote sleep?

Offering a back rub

Allowing the client to follow their usual bedtime routine (correct)

Limiting fluids for a few hours before bedtime

Asking for a prescription for sleep medication

What is a benefit of limiting fluids for a few hours before bedtime?

Enhancing cognitive function

Minimizing getting up to urinate (correct)

Promoting relaxation

Increasing REM sleep

What occurs during REM sleep?

Cognitive and brain tissue restoration Signup and view all the answers

Which of the following is a characterization of non-REM sleep stage 3?

Awakening is difficult Signup and view all the answers

What can be done to optimize the hospital environment for sleep?

Moving the client's pet to another sleep area Signup and view all the answers

Which of the following is an example of a relaxation technique?

Rubbing the client's back Signup and view all the answers

What is a consideration when creating a bedtime routine?

Including relaxing activities Signup and view all the answers

What is an important factor for the nurse to consider when collecting data about the client's difficulty sleeping?

The client's caffeine intake Signup and view all the answers

Which of the following is a common factor that might be interfering with the client's sleep?

Stress Signup and view all the answers

Which of the following recommendations should the nurse give to the client to promote sleep and rest?

Practice muscle relaxation techniques Signup and view all the answers

What is an important consideration for the nurse to optimize the hospital environment for sleep?

Maintain a comfortable temperature Signup and view all the answers

What is a benefit of practicing relaxation techniques before bedtime?

Improved sleep quality Signup and view all the answers

What is a recommended bedtime routine for promoting sleep?

Take a warm bath Signup and view all the answers

Why is it important to limit fluid intake at least 2 hours before bedtime?

To prevent frequent awakenings Signup and view all the answers

What is an important consideration for the nurse to promote sleep and rest in the hospital environment?

Alter the sleep environment for comfort Signup and view all the answers

What should the nurse do first to help the client who is having difficulty sleeping at night?

Allow the client to take a bath in the evening Signup and view all the answers

Which of the following characteristics of REM sleep should the nurse include in the presentation?

REM sleep provides cognitive restoration Signup and view all the answers

What is a sign that the client with narcolepsy understands the self-management instructions?

I'll limit my caffeine intake to one cup per day Signup and view all the answers

Which of the following bedtime routines is likely to promote better sleep?

Reading a book before bedtime Signup and view all the answers

What is a relaxation technique that can help improve sleep quality?

Doing yoga exercises before bedtime Signup and view all the answers

Which of the following exercise routines is likely to interfere with sleep?

Vigorous exercise in the evening Signup and view all the answers

What is a characteristic of REM sleep?

Vivid dreams are common during REM sleep Signup and view all the answers

What should the nurse prioritize when optimizing the hospital environment for sleep?

Ensuring the clients' room is quiet and dark Signup and view all the answers

A person with hypersomnolence disorder is likely to experience which of the following symptoms?

Excessive daytime sleepiness lasting at least 3 months Signup and view all the answers

What is the primary purpose of assessing a client's sleep patterns and history during data collection?

To identify the client's usual sleep requirements Signup and view all the answers

During Stage 3 NREM sleep, which of the following physiological changes occurs?

Vital signs decrease and it becomes more difficult to awaken Signup and view all the answers

A person with narcolepsy is at increased risk for which of the following?

Accident or injury related to sleepiness Signup and view all the answers

What is a common characteristic of Stage 2 NREM sleep?

Increased relaxation and reduced sympathetic activity Signup and view all the answers

Study Notes

Promoting Sleep and Rest

Following a regular exercise routine, at least 2 hours prior to bedtime, can help promote rest and sleep.
Limiting fluids for a few hours before bedtime helps minimize getting up to urinate.
Moving pets to another sleep area can help promote sleep.
Avoiding napping during the day can help ensure restful sleep during usual sleeping hours.
Rubbing the client's back or offering warm milk and crackers can help promote sleep.
Allowing the client to follow their usual bedtime routine represents the least change and is the first intervention to try.

REM Sleep

Cognitive and brain tissue restoration occur during REM sleep.
REM sleep typically begins about 90 minutes after falling asleep and lasts an average of 20 minutes.
Awakening is difficult in REM sleep, but relatively easy in stages 1 and 2 of non-REM sleep.
Vivid dreams are common during REM sleep.

Sleep Hygiene

Factors that might interfere with sleep include job changes, working hours, caffeine consumption, personal stress, and sleep environment.
Strategies to promote sleep include practicing muscle relaxation techniques, exercising in the morning, altering the sleep environment for comfort, and limiting fluid intake at least 2 hours before bedtime.

Narcolepsy Management

Taking short naps whenever feeling sleepy can help with narcolepsy management.
Avoiding alcohol or limiting it to one drink per day is important for narcolepsy management.

Data Collection and Nursing Interventions

When collecting data about a client's difficulty sleeping, the nurse should ask about factors such as working hours, caffeine consumption, personal stress, and sleep environment.
Nursing interventions to help the client sleep include allowing the client to follow their usual bedtime routine, rubbing the client's back, offering warm milk and crackers, and limiting fluid intake before bedtime.

Sleep Environment

A sleep-conducive environment should be maintained, free from excessive light, noise, and extreme temperatures.
Identify and eliminate sources of noise, such as children, pets, loud noises, and snoring partners.
Medications can affect sleep, with some inducing sleep but interfering with restorative sleep, while others cause insomnia.

Factors Affecting Sleep

Substance use: nicotine and caffeine are stimulants, while caffeine and alcohol can cause night awakenings.
Medications: bronchodilators and antihypertensives can cause insomnia, while prescribed stimulants can help with hypersomnolence disorder.

Nursing Actions

Establish and follow a bedtime routine to promote sleep.
Limit waking clients during the night and promote a quiet hospital environment.
Help with personal hygiene needs or a back rub prior to sleep to increase comfort.
Consider using continuous positive airway pressure (CPAP) devices for clients with sleep apnea.
Consult with the provider about trying sleep-promoting over-the-counter products (melatonin, valerian, chamomile).
As a last resort, suggest that the provider prescribe a pharmacological agent.

Sleep Disorders

Sleep apnea: characterized by more than five breathing cessations lasting longer than 10 seconds per hour during sleep, resulting in decreased arterial oxygen saturation levels.
Narcolepsy: sudden attacks of sleep that are often uncontrollable and occur at inappropriate times, increasing the risk for injury.
Hypersomnolence disorder: excessive daytime sleepiness lasting at least 3 months, impairing social and vocational activities, and increasing the risk for accident or injury related to sleepiness.

Sleep Stages

Stage 1 NREM: very light sleep, characterized by muscle relaxation, loss of awareness of surroundings, and easy awakening.
Stage 2 NREM: deeper sleep, characterized by decreased vital signs and metabolism, and requiring slightly more stimulation to awaken.
Stage 3 NREM: slow wave sleep or delta sleep, characterized by vital signs decreasing and being more difficult to awaken.
REM sleep: vivid dreaming, accounting for 20% to 25% of sleep time.

Assessment and Data Collection

Ask about sleep patterns, history, and any recent changes.
Identify the usual sleep requirements.
Ask about sleep problems (type, manifestations, timing, seriousness, related factors, aftereffects).

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Description

Learn how to promote restful sleep and rest by following a regular exercise routine, limiting fluids before bedtime, and other helpful tips. Understand the importance of sleep and how to ensure a good night's rest.