Sleep HCC

A client is undergoing overnight testing at a sleep clinic. The client's diagnostic testing includes an electro-oculogram (EOG) and electromyelogram (EMG). Evaluation of the findings from these diagnostic tests will allow the care team to determine:

the quantity of the client's REM sleep.

A nurse is discussing good sleep habits with an older adult. Which statement made by the client tells the nurse that further instruction is necessary?

"I will stay up later to make sure that I am very tired.

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."

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 female client relates that she is taking diazepam for a muscle relaxant and modafinil for treatment of narcolepsy. Additionally, she informs you that she takes a contraceptive. As part of client education, the nurse would include:

Modafinil may decrease the effects of her contraceptive, and she may need to use other protection.

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 client visits the clinic to seek treatment for disturbed sleep cycles and depressed mood. Which glands and hormones help to regulate sleep cycles and mood?

Pineal gland, melatonin

A client is admitted to the health care center with abdominal pain, nausea, and vomiting. The client has a body mass index (BMI) of 30 and reports irregular menstrual cycles and feeling tired all the time. The nurse suspects the client's symptoms to indicate which condition?

Polycystic ovary syndrome (PCOS)

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 caring for an 84-year-old female client who has been diagnosed with advanced sleep phase syndrome (ASPS). The nurse understands that treatment of this sleep disorder includes which principles?

Treatment may focus on sleep schedule changes. Treatment depends on how disruptive the client perceives the problem to be.

A new mother reports that she is exhausted and that the little sleep she gets is determined by her baby. Which suggestion should the nurse prioritize to help the mother establish healthy sleeping patterns in her infant?

Use the crib for sleeping only, not for play activities.

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.

A client has voiced concerns about her inability to fall asleep. When reviewing her history, what information would the nurse expect to find?

drinks coffee with all meals smokes 1 pack of cigarettes daily history of hyperthyroidism

A 45-year-old male client tells the nurse that he has not slept well for the past 2 weeks. Which drug might the physician prescribe for this client?

eszopiclone

As a nurse helps a client ambulate, the client says, "I had trouble sleeping last night." Which action should the nurse take first?

gathering more information about the client's sleep problem

The nurse is caring for a 6-year-old sickle-cell client in an acute care setting. A high priority for this client's plan of care is pain relief. The nurse understands that untreated acute pain can lead to which physiologic effects?

impaired mobility, anorexia, anxiety, sleep disturbances, and developmental regression

A nurse is caring for a child who was involved in a bus accident on the way home from preschool. Several people were killed in the accident. When talking with the child's parents about normal reactions to a traumatic event, the nurse should tell them that

it is normal for the child to want to sleep with them at night.

The nurse is caring for a client in her second trimester of pregnancy who is having difficulty sleeping. Which position should the nurse encourage the client to assume when resting?

left-sided Sims position with the top leg forward

A recently retired client reports that he has been able to sleep only 3 hours a night and that he has nausea, frequent urination, and headaches. He is asking the nurse what she thinks is going on with his health. What is the most probable cause of his symptoms?

moderate anxiety

The client is a 76-year-old who reports difficulty falling asleep and daytime drowsiness. Which figure best reflects REM and NREM cycles of this client?

picture - sleep diagram 1

For a client with a nursing diagnosis of Insomnia, the nurse should use which measure to promote sleep?

playing soft or soothing music

A young couple have presented to the office with concerns of possible infertility. A physical examination and complete history of the woman reveals type 2 diabetes mellitus, obesity, sleep apnea, and hypertension. The nurse would suspect:

polycystic ovary syndrome.

A chart entry on a client on the behavioral health unit reveals the client was raped 5 months earlier, is having difficulty falling asleep and staying asleep, has recurrent disturbing dreams about the rape and attributes the irritability due to the sleep deprivation. The client cannot recall details of the rape and avoids talking about them. The client feels like the rape is happening again when having sex with the spouse. The nurse recognizes that this client is experiencing symptoms of what disorder?

posttraumatic stress disorder (PTSD)

A nurse is caring for the following clients. Which client should the nurse evaluate first?

An 18-year-old male who appears to be sleepwalking in the hallway

The nurse is educating the parents of a newborn prior to discharge home. The parents demonstrate teaching was successful when making which statement(s)?

"I understand it is normal for newborns to lose 5% to 10% of their bodyweight after birth." "I will not be concerned if my newborn has stools that begin to have a yellowish color to them." "My newborn can see up-close things, like our faces, better than things at a distance."

A health care provider specializes in treating conditions classified as parasomnias. Which client should the nurse refer to this provider?

A 25-year-old who sleepwalks

The nurse is caring for a group of clients in the hospital. Which client is at most risk for obstructive sleep apnea?

A male client with a neck circumference of 44 having a laparoscopic cholecystectomy

A client tells the health care provider he has been experiencing insomnia. Select the most important questions for the nurse to ask the client.

"Are you experiencing any pain?" "Have you been traveling recently?" "Tell me where you sleep?" "Do you perform shift work?"

When providing discharge teaching for a client with multiple sclerosis (MS), the nurse should include which instruction?

"Avoid hot baths and showers."

The nurse moves a confused, disruptive patient to a private room at the end of the hall so that other patients can rest, even though the confused patient becomes more agitated. The nurse's intervention is consistent with what moral theory?

"Consequentialism," by which good consequences for the greatest number are maximized

The parents of an adolescent are concerned about his mental health and have brought the adolescent into the physician's office for an evaluation. Which statements by the parents indicate that the child may have a mental health disorder?

"He has lost 10 pounds over the last 4 months." "He used to be a straight-A student and now he's bringing home Cs and Ds." "He has started sleeping for only 3 hours each night."

A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when they say

"I should become involved in a weight loss program."

A parent brings a 10-year-old child to the clinic because of sleepwalking at least two to three times per week. The parent is very concerned and asks the nurse what should be done when the child is found to be sleepwalking. What is the nurse's best response?

"Make sure the environment is safe and place bolts on doors and windows."

While working for a neurologist who is assessing a client experiencing restless legs syndrome (RLS), the nurse should be prepared to answer the question about why the client needs to have iron level drawn? The nurse response should include:

"Many clients with RLS also have an iron-deficiency anemia as well."

The nurse is caring for a child with attention deficit hyperactivity disorder who is experiencing insomnia related to the prescribed psychostimulant. The parents are considering stopping the medication and want to know if there are other options. Which response by the nurse would be most appropriate?

"Speak to the doctor about atomoxetine."

The nurse is providing anticipatory guidance to the parents of a 15-year-old who voice concerns with their teenager's sleep habits. They state, "Left to her own devices, I'm sure she'd stay up until 3:00 in the morning on the weekends and sleep until after lunchtime." Which should the nurse explain to the parents?

"That must be hard for you to manage. Perhaps we can explore some strategies with her to establish more predictable sleep patterns." "This is expected at this stage of development. Are there any ways that you could adjust your family routines to accommodate this?"

Parents of a preschooler tell the nurse that their child often refuses to go to sleep at night. Which suggestion by the nurse would be helpful?

"Try reading a favorite story before bedtime." "Set up some familiar bedtime rituals for your child." "Try using a night light in the child's room." "Avoid having your child watch frightening shows on TV before bedtime."

A nurse is caring for a client who is 2 days postpartum. The client asks the nurse how many hours of the day she should expect her infant to sleep. What is the most appropriate answer?

16-20 hours

The electroencephalogram currently shows brain waves of high voltage and the client demonstrates slow, rolling eye movements. Which sleep phase is the client in?

3

A nurse is performing an intake assessment for a client admitted to the hospital with hypertension. The client informs the nurse that she drinks alcohol in the evening to help her sleep. What does the nurse know about the induction of sleep through alcohol intake?

Alcohol induces sleep initially and disrupts and fragments sleep.

Parents say they have been using measures to lessen the struggle of getting their preschooler to bed at night and to sleep. Which practice will the nurse suggest they discontinue?

Allowing the preschooler to fall asleep wherever and whenever the child is tired enough

Which disease often results in more frequent periods of nighttime awakening and daytime sleeping?

Alzheimer disease

A nurse is caring for a client with a pulmonary infection secondary to acquired immunodeficiency syndrome (AIDS). Which intervention would be most effective to manage night sweats?

Administer an antipyretic medication prophylactically as needed before the client goes to sleep.

When completing a physical assessment of an individual's response to stress, the nurse should observe and inquire about what?

Appetite and sleep

The parent of an 11-month-old infant reports to the nurse that the infant sleeps much less than other children. The parent asks the nurse whether the infant is getting sufficient sleep. What should be the nurse's initial response?

Ask the parent for more information about the infant's sleep patterns.

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.

The psychiatric mental health nurse is working with a client who has been diagnosed with posttraumatic stress disorder (PTSD). Assessment reveals that the client is experiencing frequent episodes of intrusion. The nurse should consequently prioritize what assessment?

Assessing the quantity and quality of the client's sleep

A 5-year-old child has starting sitting up in bed displaying signs of extreme anxiety. In the morning, when the parents ask the child about this, he has no recollection. What should the nurse convey to the parents if this happens again?

Assist the child in settling down without awakening him or her after an episode.

An adult client is experiencing chronic insomnia related to a recent divorce and child custody proceedings. The client is requesting a renewable prescription for "sleeping pills." The nurse knows that which intervention will provide the most beneficial treatment for this client?

Behavioral therapies and education regarding sleep hygiene will provide assistance for the client.

A nurse is assisting with the performance of an electroencephalogram (EEG) to determine brain wave activity. The client is observed having periods of blinking, staring, and not responding for approximately 30-second periods. Which of the following does the nurse recognize as a reassuring pattern of brain waves?

Brain waves of various frequencies and amplitude

The mother of a 10-year-old child diagnosed with rubella asks what can be done to help her child feel better during her illness. What information can be provided?

Encourage rest and relaxation.

The nurse is caring for a client with bipolar disorder who was recently admitted to an inpatient unit and is experiencing a manic episode. What is a priority nursing intervention for this client?

Closely monitor the client's eating and sleeping habits.

A nurse is obtaining the health history of a 72-year-old woman who has come to the ambulatory care center for an evaluation. When obtaining information about the woman's sleep patterns, which of the following would the nurse expect to assess?

Complaints about frequently waking up during the night

The nurse is preparing to initiate PCA therapy for a client with sleep apnea. What is the correct action by the nurse?

Contact the physician.

Which of the following is the most effective treatment for obstructive sleep apnea (OSA)?

Continuous positive airway pressure (CPAP)

A client on the medical-surgical unit is scheduled for several diagnostic tests. The nurse is concerned that the tests will be too tiring for the client. What would be the nurse's most appropriate action?

Coordinate with the other disciplines to schedule the tests with adequate rest for the client.

A client reports insomnia during a routine visit. What should the nurse assess first regarding the most likely cause?

Daily intake of caffeine-containing products

Which of the following describes awakening at night to urinate?

Nocturia

A client, now 37 weeks pregnant, calls the clinic because she is concerned about being short of breath and is unable to sleep unless she places three pillows under her head. After listening to the client's concerns, the nurse should take which action?

Explain that these are expected problems for the latter stages of pregnancy.

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.

A nurse observes clusters of rapid eye movements (REMs) in a sleeping client. Additional characteristics of the sleep cycle that this client is experiencing include:

Increased cerebral activity

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 discussing a 6-year-old pediatric client's sleep characteristics with the child's mother. The mother states that her child sometimes awakens her with fits of crying and appears to be very frightened. The mother asks the nurse what she should do when this happens. What is the most appropriate direction from the nurse?

Instruct the mother to help the child settle without trying to awaken the child.

A nurse is caring for a client diagnosed with Alzheimer disease who sleeps at irregular intervals, having no consistent sleep-wake cycle. The nurse suspects that the client is experiencing:

Irregular sleep-wake rhythm

A client who is considered legally blind is diagnosed with a free-running sleep disorder (FRSD) after frequent reports of difficulty sleeping. Which scenario would the nurse advise for this client?

Maintaining a regular sleep-wake schedule

Serotonin abnormalities are thought to be involved in the following disorders:

Mental depression and sleep disorders.

A nurse is administering a CNS stimulant to a client with narcolepsy. The nurse understands that this drug does not cause cardiac and other systemic stimulatory effects like other CNS stimulants. Which drug is the nurse administering?

Modafinil

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 educating the new mom about the sleep patterns of a newborn. Which statement should she include in her education?

Newborns usually sleep ~16-20 hours/day.

A patient admitted to the health care facility for insomnia related to stress is prescribed a sedative. What intervention should the nurse perform to promote the effects of the sedative?

Provide back rubs

A client has been taking nonprescription melatonin to help the fall asleep and remain asleep throughout the night. The client states that it worked for a brief period but now requires additional help. Which pharmacologic melatonin receptor agonists should the nurse anticipate being prescribed by the healthcare provider?

Ramelteon (Rozerem)

Fentanyl has been administered to a client in labor. What assessment should the nurse prioritize?

Respiratory status

The nurse is performing a physical health assessment of a client who has been diagnosed with posttraumatic stress disorder (PTSD). What aspect of this assessment should the nurse prioritize?

Sleep assessment

Which is the most frequent and persistent bereavement-associated symptom?

Sleep disturbances

A client in her second trimester of pregnancy arrives at a health care facility reporting heartburn. What instructions should the nurse offer to help the client deal with heartburn?

Sleep in a semi-Fowler position. Limit consumption of food before bedtime. Avoid overeating.

A nurse is caring for a client who reports a terrifying experience of being unable to move, speak, or take a deep breath upon awakening. What has the client likely experienced?

Sleep paralysis

What are some examples of healthy self-care behaviors everyone should adopt?

Sleeping 7 to 8 hours each night Eating regular healthy meals Maintaining an ideal body weight

Restless legs syndrome (RLS) is a disorder that has its peak onset in middle age. Diagnosis of RLS is based on a history of what?

Symptoms that become worse in the evening

The nurse is giving a back massage to a client who is having trouble sleeping. Which nursing actions are performed appropriately?

The nurse assists the client to a prone position and drapes the client's body as needed with the bath blanket. The nurse applies warmed lotion to client's shoulders, back, and sacral area. The nurse places hands at the base of the spine and strokes upward to the shoulder and back down to the buttocks.

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.

A client is ordered sertraline, a selective serotonin reuptake inhibitor (SSRI). Which adverse effects should the nurse include when creating a medication teaching plan? Select all that apply.

agitation dry mouth sleep disturbance

A client was seen in the clinic for musculoskeletal pain, fatigue, mood disorders, and sleep disturbances. The physician has diagnosed fibromyalgia. What would not be a part of teaching plan for this condition?

applications of ice

To obtain subjective data about a newly admitted client's sleep pattern, the nurse:

asks the client what promotes sleep.

An older adult client is prescribed a sedative for the treatment of insomnia. The nurse would suspect that the client is experiencing an adverse reaction to the drug based on assessment of which of the following?

confusion

A patient asks the nurse if it would be all right to take an over-the-counter antihistamine for the treatment of a rash. What should the nurse educate the patient is a major side effect of antihistamines?

sedation

What are some negative effects that chronic pain can have on the pediatric population?

sleep disturbances, exhaustion, irritability, mood disturbances, and depression

Which parasomnia occurs primarily in children in the non-REM stage and may result in emotional experiences that are frightening?

sleep terrors

When teaching parents of a neonate the proper position for the neonate's sleep, a nurse stresses the importance of placing the neonate on his back to reduce the risk of

sudden infant death syndrome (SIDS)