NURS 201: Week 10 - Sleep & Rest/Teaching & Learning

Caffeinated beverages should be limited to how many per day to aide in sleep?

1 or 2 a day and none in the evening

Benzodiazepines half life

20-100 hours

How many stages of nonrapid eye movement (NERM) sleep?

3 stages

length of sleep cycle

90-100 minutes

Parasomnias

Abnormal behaviors such as nightmares or sleepwalking occur during sleep. Somnambulism, Night terrors, Nightmares, Nocturnal enuresis (bed-wetting) More common with Children, Bruxism.

Circadian disorders

Abnormality in sleep/wake times Caused by rapid time-zone changes (jet lag), shiftwork (night shift), or change in total sleep time from day to day.

Obstructive sleep apnea (OSA) risk factors

Age Obesity Male

Teaching

An interactive process that promotes learning.

How can nurses help motivate?

Assess patient's feelings When will they be able to utilize what you are teaching? Give feedback

nursing process (ADPIE)

Assessment Diagnosis Planning Implementation Evaluation

A 4-year-old pediatric patient resists going to sleep. To assist this patient, the best action to take would be: A. adding a daytime nap. B. allowing the child to sleep longer in the morning. C. maintaining the child's home sleep routine. D. offering the child a bedtime snack.Quick Quiz!

C

Nurses must possess the knowledge and skills needed for patient teaching so that A. They can complete the documentation forms related to client teaching accurately. B. They can help the hospital meet The Joint Commission standards requiring client teaching. C. They can promote the health, safety, and rights of clients through education. D. They can meet the patient rights delineated in the "Patient Care Partnership."

C

Restless Leg Syndrome (RLS)

CNS disorder characterized by uncontrollable movement of legs while resting or before sleep onset

Mixed apnea

CSA and OSA

herbs that promote sleep

Chamomile, lavender, valerian root

Insomnia

Chronic inability to fall asleep, remain asleep, or go back to sleep. Frequent awakenings, daytime drowsiness Occurs at least 3 nights/wk for 3 months or longer.

parts to cognitive knowledge

Comprehension Application Analysis Synthesis Evaluation

sleep

Cyclical states/altered consciousness Decreased motor activity/perception Selective response to external stimuli

During rounds on the night shift, you note that a patient stops breathing for 15 to 20 seconds several times during the shift. This condition is known as: A. cataplexy. B. insomnia. C. narcolepsy. D. sleep apnea.

D

Central Sleep Apnea (CSA) causes

Dysfunction of respiratory control center = CNS Prematurity Brainstem injury- head trauma Medications- opioids, tranquilizers Problems affecting the brainstem- infection, stroke

sleep deprivation causes

Emotional stress, Medications, Environmental disturbances, Symptoms

(T/F) Most health-related lifestyle behaviors are inherently enjoyable and intrinsically motivated.

False

Tips for Adult learners

Identify their own learning needs Why it is important Teach close to time they use it Partner with your patient Discuss "Need to Knows"

Benefits of sleep

Increases mental performance by improving learning and storing long-term memory Repair Energy Reduces stress/anxiety, improves ability to cope Strengthens immune system

Adult learners attitudes

Independent & self directed Recognize need before willingness to learn More motivated if able to apply immediately Prefer to be partners in the learning process May be resistant to learn

Circadian rhythm

Internal clock, 24-hour day/night sleep/wake pattern Rhythm of sleep frequently becomes synchronized with other body functions. Affected by light, temperature, social activities, and work routines.

rest

Mild to no activity Relaxation; stress free Refreshing

What is the #1 factor affecting learning?

Motivation

Factors That Affect Learning

Motivation/Readiness/Developmental Stage/Complexity Timing/Environment/Scheduling Active Involvement Feedback/Communication Repetition

sleep medications

Nonbenzodiazepines Benzodiazepines Barbiturates Selective melatonin agonists Tricyclic antidepressants Nonprescription sleep meds (Antihistamines, Melatonin, Herbs)

most common type of sleep apnea

OSA

Why nurses teach

Patients and nurses are involved in shared decision making Hospital stays are brief Healthcare is expensive

sleep apnea

Periodic breathing cessation for at least 10 sec during sleep

4 phases of sleep

REM NREM-1 NREM-2 NREM-3

REM sleep

Rapid eye movement sleep Vivid dreams commonly occur

Reticular activating system (RAS)

Responsible for maintaining wakefulness

sleep history

Sleep log for 14 days Description of sleeping problems, current life events, physical and psychological illness, emotional and mental status, behaviors of sleep deprivation

SMART goals

Specific, Measurable, Attainable, Relevant, Time sensitive

Learning

The purposeful acquisition of new knowledge, attitudes, behaviors, and skills.

Nonbenzodiazepines examples

Zolpidem tartrate Zaleplon

drugs that influence sleep

Zolpidem tartrate, hypnotics, diuretics, opioids, antidepressants, alcohol, caffeine, beta-blockers, anticonvulsants

Psychomotor (Skills)

acquiring skills that require mental and muscular activity

EEG alpha waves???????????????????

awake but relaxed

Reticular activating system (RAS) location

brain stem

The nurse has assessed the patient and has created a teaching plan. The nurse is worried about the patient being compliant. What is a predominant factor that the nurse should consider? a. Financial b. culture c. motivation d. time

c

3 domains of learning

cognitive affective psychomotor

The nurse is evaluating the responses of clients to teaching sessions. An example of an evaluation of a psychomotor skill is: a. client is able to state side effects of medication b. client responds appropriately to eye contact c. client planned an exercise program d. client uses the cane correctly

d

Benzodiazepines examples

diazepam lorazepam triazolam alprazolam flurazepam

Hypersomnia

excessive sleeping, especially in the daytime.

Affective (feelings)

expression of feelings and acceptance of attitudes, opinions, or values Receiving Characterizing

controls circadian rhythm

hypothalamus

Cognitive (Thinking)

includes all intellectual behaviors and requires thinking

Most common sleep disorder

insomnia

sleep deprivation

lack of sleep

Obstructive sleep apnea (OSA) treatment

lifestyle changes (weight loss), use of a breathing assistance device at night (continuous positive airway pressure - CPAP)

OSA

obstructive sleep apnea

Electroencephalogram (EEG)

record of the electrical activity of the brain

somnambulism

sleepwalking

Obstructive sleep apnea (OSA) symptoms

snoring loudlyand feeling tired even after a fullnight's sleep

cataplexy

sudden loss of muscle control

Narcolepsy

uncontrollable sleep attacks

Barbiturates

•Deprive people of REM Sleep •Life threatening breathing problems

Benzodiazepines

►Long acting ►May cause daytime sleepiness ►Seizures

Nonbenzodiazepines

►Shorter Half-life ►Doesn't cause Daytime sleepiness ►Ambien half life 2 hours