sleep 34
A client with difficulty sleeping is prescribed ramelteon. The client asks the nurse, "How does this medicine work?" Which information would the nurse include in the response?
Activates the receptors for the hormone melatonin
Which interview question would be the best choice for the nurse to use to assess for recent changes in a client's sleep-wakefulness pattern?
Do you usually go to bed and wake up about the same time each day?
Which client could be diagnosed with insomnia?
A 50-year-old woman who is reporting increased irritability for the past 2 months. She states that she goes to bed at 10 p.m. every night and tries to sleep in but, no matter what she does, she always wakes up around 4 a.m.
The client reports unpleasant sensation in the legs with an urge to move them. Which questions will be important for the nurse to ask to determine what the client is experiencing? Select all that apply.
"Have you been using any type of antihistamines for allergies?" "Do you use tobacco products?" "Does massaging the legs provide any relief?"
A nurse is conducting an assessment of a middle-aged client who reports difficulties with sleeping at night. Which information would the nurse correlate with the client's sleep-wakefulness pattern? Select all that apply.
"I usually go to bed around 9 and get up at about 7." "I usually get up two to three times a night to urinate."
The nurse is promoting bedtime rituals with a family. Which statement indicates the nurse may need to provide further instructions to the mother?
"My boys love to roughhouse in their room right before bedtime."
A client reports to the nurse, "Sleep really isn't necessary." Which teaching by the nurse is appropriate? Select all that apply.
"Sleep helps your blood flow to the brain." "Sleep helps you to learn easier and remember more." "Sleep helps your immune system to fight off infections."
Parents tell the nurse that their 5-year-old is only sleeping 10 hours now and is refusing to take an afternoon nap. The nurse should teach the parents:
"This is normal development for children in this age group."
A new mother calls the pediatric nurse to talk about her baby, who sleeps "all day long." The nurse informs the new mother that an infant requires how many hours of sleep?
14 to 20 hours each day
The caregiver of a preschool-age child tells the nurse, "I am afraid my child sleeps too much," and reports that the child takes a daily 2-hour nap in addition to sleeping 12 hours at night. What is the appropriate nursing response?
"Your child should get 10-13 total hours of sleep time in a 24-hour period."
A nurse is visiting the home of a first-time mother and her newborn. The nurse is teaching the mother about the newborn's sleep needs. The nurse would inform the mother that newborns sleep approximately how many hours per day?
14 to 20 hours
Which is not a lifespan consideration for sleep cycles?
By middle age, the frequency of nocturnal awakenings decreases, and satisfaction with sleep quality increases.
The nurse is caring for new parents. During her education session, the nurse instructs the parents on a newborn's sleep patterns. Which statement is accurate about a newborn's sleep patterns?
Newborns sleep 16 to 17 hours per day.
The nurse is implementing comfort measures to promote sleep for a client. Which intervention is the best choice for the client?
Offer client a small carbohydrate and protein snack before bedtime. cool and dark room
The nurse is teaching a client with seasonal affective disorder about proper use of a full-spectrum light. Which teaching will the nurse include?
Sit within 3 ft (1 m) of the light for approximately 2 hours soon after awakening.
The nurse is completing an admission assessment for a client scheduled for back surgery after a construction accident. The nurse notes the client is having slowed speech and focus, irritability, yawning, and that he reports severe lumbar and right leg pain. The nurse suspects a nursing diagnosis of:
Sleep Pattern Disturbance related to acute pain.
A maternity nurse is instructing new parents on the proper sleeping position for their newborn child. In what position does the nurse instruct the parents to place the infant?
Supine position
A client taking a diuretic twice daily for treatment of hypertension reports being awakened often by a full bladder. What teaching regarding the diuretic will the nurse provide?
Take it before 6:00 p.m. at night.
The student nurse is providing an education program for preschool parents. The nursing student should include which intervention to improve the child's sleep?
The child should limit fluids after supper.
A nurse is reviewing the medication administration record. Which order does the nurse question?
a diuretic administered twice daily at 9 a.m. and 9 p.m.
The nurse is performing an intake assessment of a 60-year-old client who admits to having a nightcap of 4 to 6 ounces of scotch whisky each night. What effect might this alcohol be having on the client's sleep?
decreased REM sleep
When a client tells the clinic nurse that he has irresistible sleep attacks throughout the day lasting from 10 to 15 minutes, the nurse suspects that the client may be experiencing what?
narceolpsey
In Stage 4 sleep, the:
pulse rate is slow
A nurse is discussing sleep with a group of orienting unlicensed personnel. The nurse explains that the older adults can have issues with physical safety in relation to the sleep patterns because:
they may be disoriented on awakening.
A nursing student is changing the client's bed. Which action requires intervention from the nursing instructor?
tossing soiled linen on the floor
A nurse is developing a teaching plan for a client diagnosed with obstructive sleep apnea. Which item would the nurse instruct the client to avoid to reduce the disrupted breathing pattern when asleep?
alcohol tobacco sleeping pills
The nurse should obtain a sleep history on which clients as a protocol?
all clients admitted to a health care agency
The nurse is encouraging a client to begin and maintain a sleep diary. What statement made by the client indicates an understanding of the purpose of the diary?
"I will record the time I go to bed and how long it takes me to fall asleep."
A client comes to the clinic and states to the nurse, "I am traveling overseas for a project frequently and am having a difficult time adjusting because of jet lag. What is the best response by the nurse?
"Light therapy can be beneficial and help ease the transition to a new time schedule or zone."
The nurse is providing discharge instructions for a new mother about sleep practices for her newborn child. The mother will be breastfeeding her infant. Which pertinent information will the nurse provide?
"Your newborn will probably sleep an average of 16 hours each day."
A newly admitted client states to the nurse, "I average about 5.5 hours of sleep per night." What determination of this client's sleep patterns does the nurse discuss with the client?
A newly admitted client states to the nurse, "I average about 5.5 hours of sleep per night." What determination of this client's sleep patterns does the nurse discuss with the client?
A client has been in the hospital for the past 10 days following the development of an infection at her surgical incision site. Each morning, the client reports overwhelming fatigue and has told the nurse, "I just can't manage to get any sleep around here." How should the nurse first respond to this client's statement?
Assess the factors that the client believes contribute to the problem.
A nurse is caring for a client who has been diagnosed with a disturbed sleep pattern. Which measures should the nurse implement to promote sleep? Select all that apply.
Assisting with progressive relaxationProviding a back massagePromoting daytime exercises
What factor has been hypothesized by researchers regarding current thoughts on sleep?
Chronic sleep deprivation is present.
The client has been in the intensive care unit for several days. The client appears to be sleeping throughout the night. The nurse records the data listed above. The nurse evaluates that rapid eye movement (REM) sleep is occurring at:
During REM sleep, the client's temperature, pulse, blood pressure, and respirations increase. The client may experience small muscle twitching, such as facial muscles twitching, and irregular pulse rate and respirations. During non-eye movement sleep, the client will exhibit a decrease in body temperature, pulse, blood pressure, and respirations.
Which activity would be appropriate to suggest to the client who reports having difficulty falling asleep every evening?
Eat peanut butter crackers Carbohydrates make tryptophan more available to the brain, thereby promoting sleep. Therefore, a small snack containing protein and carbohydrates (such as peanut butter on toast or cheese and crackers) is effective.
An older adult client with mild hypothermia has been admitted to the health care facility. What should the nurse do to provide an appropriate environment to an older adult client?
Ensure that the environment is warmer.
A nurse notes that a client admitted to a long-term care facility sleeps for an abnormally long time. After researching sleep disorders, the nurse learns that which area of this client's brain may have suffered damage?
Hypothalamus
The nurse is caring for a client who reports insomnia. The client has recently moved from an area near a fire station in the inner city to the country. Which recommendation will the nurse make to facilitate sleep?
Find a phone app that plays sounds of the city.
Which statement about the sleep patterns of toddlers should the nurse incorporate into an education plan for parents?
Getting the child to sleep can be difficult.
A client reports periodic difficulty falling asleep. Which teaching will the nurse provide? Select all that apply.
Go on a daily walk. Adhere to a regular schedule for waking and going to sleep. Decrease caffeine intake.
The pediatric nurse teaches parents about normal sleep patterns in their children. Which education point should the nurse include?
Inform parents that daytime napping decreases during the preschool period, and, by the age of 5 years, most children no longer nap.
The nurse is assessing a client and determines that they are in rapid eye movement (REM) sleep. What finding indicates to the nurse that the client is in this stage?
There is rapid eye movement under the eyelids.
For the last 3 weeks, a nurse in a long-term care facility has administered a sedative hypnotic to a client who complains of insomnia. The client does not seem to be responding to the drug and is now lying awake at night. What is the most likely explanation?
Most sedative hypnotics lose their effect after 1 or 2 two weeks of administration.
A new client in the medical-surgical unit complains of difficulty sleeping and is scheduled for an exploratory laparotomy in the morning. The nursing diagnosis is Sleep Pattern Disturbance: Insomnia related to fear of impending surgery. Which step is most appropriate in planning care for this diagnosis?
Provide an opportunity for the client to talk about concerns.
The nurse is creating a plan of care for a client that is reporting an inability to sleep and rest. What outcome criterion will the nurse address for a goal that the client will demonstrate physical signs of being rested?
The client has decreases in circles under the eyes and excessive yawning by 1 week
A client is worried and states, "I just know I won't be able to sleep before my surgery." What sleeping pattern would the nurse anticipate?
The client will likely not be able to sleep.
A nurse on the night shift checks on a client and suspects that the client is in REM sleep. Which client cue is indicative of this stage of sleep?
The client's eyes dart back and forth quickly
The client is scheduled for a polysomnography to determine if the client has obstructive sleep apnea (OSA). The nurse instructs the client to:
anticipate sleeping overnight at a health care center.
Which physiologic change occurs during non-rapid eye movement (NREM) sleep?
decreased brain activity from wakefulness
A nurse is caring for a client diagnosed with sleep apnea. Which nursing diagnosis should the nurse include in her nursing care plan?
impaired gas exchange
A client is undergoing a sleep study and appears to be in the stage of rapid eye movement sleep. When assessing the client, which finding would the nurse correlate with this stage of sleep? Select all that apply.
increased temperature increased respiratory rate During REM sleep, the pulse, respiratory rate, blood pressure, metabolic rate, and body temperature increase, whereas general skeletal muscle tone and deep tendon reflexes are depressed.
Which factor has the most influence on an individual's sleep-wake patterns?
inner biologic clock
A nurse at the health care facility is caring for an older adult client who complains of sleeplessness. Which condition is a manifestation of depression in an older client?
insomnia
The nurse is discussing sleep interventions with a client. What statement made by the client indicates an understanding of sleep restriction?
limiting time in bed to actual sleep time
When the newly admitted client with chronic obstructive pulmonary disease informs the nurse that she frequently awakens during the night, the nurse may notify the physician for which intervention?
low flow oxygen
The nurse is assessing a client for sleep disorders. The initial step in sleep assessment is:
observe the client's hours of sleep and review the client's sleep diary.
A nurse working in a health clinic assesses sleep patterns during each health assessment. Based upon the nurse's knowledge regarding sleep needs, the nurse recognizes which age group as generally needing the least amount of sleep?
older adults
Which factor necessitates the need for more sleep in the adolescent population?
rapid growth
The client being seen in the employee wellness clinic reports difficulty sleeping for the past several months. The most important assessment the nurse could make is:
reviewing the client's sleep diary for the past 2 weeks.
Which problem is associated with obesity, heavy snoring, and shallow breathing?
sleep apnea
The nurse is caring for a client with narcolepsy. The client reports experiencing being unable to move upon awakening from sleep. The client's spouse states that the client makes sandwiches in the middle of the night, yet the client does not recall this behavior. How does the nurse document these concerns?
sleep paralysis and automatic behavior
The nurse is caring for a client with narcolepsy. The client reports experiencing being unable to move upon awakening from sleep. The client's spouse states that the client makes sandwiches in the middle of the night, yet the client does not recall this behavior. How does the nurse document these concerns?
sleep paralysis and automatic behavior Automatic behavior is the performance of routine tasks without full awareness, or later memory, of having done them. Sleep paralysis occurs when the person cannot move for a few minutes just before falling asleep or awakening. Cataplexy occurs with a sudden loss of muscle tone triggered by an emotional change such as laughing or anger. Hypnogogic hallucinations are dream-like auditory or visual experiences while dozing or falling asleep.
A client who works night shift is struggling with sleeping during the day after working all night. What actions can the nurse suggest to help promote sleep?
sleeping in a room with curtains that block the light eating breakfast before going to sleep
A client has voiced concerns about her inability to fall asleep. When reviewing her history, what information would the nurse expect to find? Select all that apply
smokes 1 pack of cigarettes daily drinks coffee with all meals history of hyperthyroidism
A client has voiced concerns about her inability to fall asleep. When reviewing her history, what information would the nurse expect to find? Select all that apply.
smokes 1 pack of cigarettes daily drinks coffee with all meals history of hyperthyroidism
The nurse is completing a sleep history on a client who reports sleeping problems. Which of the client's regular behaviors will cause the client to have difficulty with sleep?
taking a diuretic at 9 a.m. and 5 p.m. daily
The nurse is caring for a client who is having difficulty sleeping. Which medication does the nurse anticipate will be prescribed by the health care provider?
temazepam Benzodiazepines such as temazepam are often used to treat difficulty sleeping.
The nurse makes the following assessment. A middle-age client reports falling asleep frequently at his job during the day, feels like he is not getting enough sleep at night (even though the number of hours of sleep is unchanged), continues to feel tired, and is not able to think clearly. Also, the client reports his wife believes he is irritable upon awakening. Nursing interventions include teaching the client to:
use caution when driving an automobile. The client is describing hypersomnia and is at increased risk for a motor vehicle accident when drowsy while driving an automobile. The client is to avoid alcohol, caffeine, and late-night activities.
An 82-year-old client is newly admitted to an assisted living facility. Which intervention promotes safety at night for the client?
using a night light in the bathroom
