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Questions and Answers
What can be done to promote rest and sleep?
Which of the following is an example of a least restrictive intervention to promote sleep?
What is a benefit of limiting fluids for a few hours before bedtime?
What occurs during REM sleep?
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Which of the following is a characterization of non-REM sleep stage 3?
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What can be done to optimize the hospital environment for sleep?
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Which of the following is an example of a relaxation technique?
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What is a consideration when creating a bedtime routine?
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What is an important factor for the nurse to consider when collecting data about the client's difficulty sleeping?
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Which of the following is a common factor that might be interfering with the client's sleep?
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Which of the following recommendations should the nurse give to the client to promote sleep and rest?
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What is an important consideration for the nurse to optimize the hospital environment for sleep?
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What is a benefit of practicing relaxation techniques before bedtime?
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What is a recommended bedtime routine for promoting sleep?
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Why is it important to limit fluid intake at least 2 hours before bedtime?
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What is an important consideration for the nurse to promote sleep and rest in the hospital environment?
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What should the nurse do first to help the client who is having difficulty sleeping at night?
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Which of the following characteristics of REM sleep should the nurse include in the presentation?
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What is a sign that the client with narcolepsy understands the self-management instructions?
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Which of the following bedtime routines is likely to promote better sleep?
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What is a relaxation technique that can help improve sleep quality?
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Which of the following exercise routines is likely to interfere with sleep?
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What is a characteristic of REM sleep?
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What should the nurse prioritize when optimizing the hospital environment for sleep?
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A person with hypersomnolence disorder is likely to experience which of the following symptoms?
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What is the primary purpose of assessing a client's sleep patterns and history during data collection?
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During Stage 3 NREM sleep, which of the following physiological changes occurs?
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A person with narcolepsy is at increased risk for which of the following?
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What is a common characteristic of Stage 2 NREM sleep?
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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.
