Chapter 33: Rest and Sleep

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 rough-house in their room right before bedtime."

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."

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:

0100.

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

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

REM sleep in a toddler is about:

30%

A nurse is reviewing the medication administration record. Which order does the nurse question?

A diuretic administered twice daily at 9am and 9pm.

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.

What factor has been hypothesized by researchers regarding current thoughts on sleep?

Chronic sleep deprivation is present.

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 activity would be appropriate to suggest to the client who reports having difficulty falling asleep every evening?

Eat some crackers with peanut butter at bedtime.

The nurse is caring for a client who reports insomnia. The client has recently moved from an area nearby 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.

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 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.

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 managing the environment for clients on a busy hospital ward. Which interventions would the nurse perform to facilitate a more restful environment? Select all that apply.

Maintain a brighter room during daylight hours and dim lights in the evening. Decrease the volume on alarms, pages, telephones, and staff conversations. Medicate for pain if needed

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.

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 patters?

Newborns sleep 16 to 17 hours per day.

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.

A nurse is caring for a client with restless leg syndrome who complains of sleeplessness. Which nursing diagnosis is most appropriate for this client?

Sleep Deprivation

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 client begins snoring and is sleeping lightly. The stage of sleep is:

Stage 2

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 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.

Which guideline does the nurse apply to discussion of sleep patterns with older adult clients?

Total sleep time decreases as the clients age.

A client tells the nurse that the client often has a difficult time falling asleep at night. What suggestion offered by the nurse may assist the client in achieving sleep?

a snack containing carbohydrates and protein

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.

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

Which activity for rest break should not be incorporated into care planning for clients to aid in healing and recovery?

drinking an 8 oz cup of a caffeinated beverage

While instructing young adults about the need for adequate sleep, the nurse instructs the group that to improve sleep quality, individuals should:

have a consistent time for arising.

In Stage 4 sleep, the:

pulse rate is slow

Which factor necessitates the need for more sleep in the adolescent population?

rapid growth

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 who is having difficulty sleeping. Which medication does the nurse anticipate will be prescribed by the healthcare provider?

temazepam (Restoril)

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.

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 are 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 nurse is providing client education for the parents of an obese child diagnosed with obstructive sleep apnea. What treatment measures would the nurse explain during the education session? Select all that apply.

use of a mandibular advancement device (MAD) use of a continuous passive airway pressure (CPAP) machine a weight loss plan

An 82-year-old client is newly admitted to an assistive living facility. Which intervention promotes safety at night for the client?

using a night light in the bathroom