Sleep
A 12-year-old child is sent home for pediculosis after being at camp for 1 week. The mother thinks others at camp have it. The mother asks the nurse how her son could have gotten pediculosis. How should the nurse reply?
"Children who sleep close to someone who has it get it more easily."
The parent of a preschool-age child has been told the child has sleep terrors. Which statement should the nurse include when teaching the parents about sleep terrors?
"Intervention is required only if it is necessary to protect the child."
A client taking clozapine states, "I don't like feeling so sedated during the day. I can hardly keep my eyes open." Which response by the nurse would be most appropriate?
"Let's talk to your health care provider about taking most of the drug at bedtime."
A client receiving radiation therapy for lung cancer is having difficulty sleeping. What should the nurse do first when teaching the client about promoting sleep?
Ask the client about usual sleep patterns.
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 is admitted to the acute psychiatric care unit after 2 weeks of increasingly erratic behavior. He has been sleeping poorly, has lost 8 lb (3.6 kg), is poorly groomed, exhibits hyperactivity, and loudly denies the need for hospitalization. Which nursing intervention takes priority for this client?
Decreasing environmental stimulation
A 13-year-old male was kidnapped and held for ransom by two criminals. His parents asked to have him admitted to the adolescent psychiatric unit. He is sleep-deprived, filthy, alternating between sobbing and making threats to kill his captors, suspicious, and easily startled. He signs a no harm contract and then asks to go to sleep. What is the best initial plan for this client?
Develop trust and allow him to talk about his memories and feelings.
Two nurses are working the night shift on a medical unit. The first nurse completes an initial shift assessment on assigned clients. One hour later, the second nurse finds the first nurse asleep in the lounge. The first nurse remains asleep for the next 4 hours and then wakes up to do client rounds. What should the second nurse do in this situation?
Discuss the situation with the first nurse, including the safety implications of sleeping on the job.
During a home visit to an older adult with mild dementia, the client's daughter reports that she has one major problem with her mother. She says, "She sleeps most of the day and is up most of the night. I can't get a decent night's sleep anymore." Which suggestions should the nurse make to the daughter? Select all that apply.
Establish a set routine for rising, hygiene, meals, short rest periods, and bedtime. Engage the client in simple, brief exercises or a short walk when she gets drowsy during the day. Promote relaxation before bedtime with a warm bath or relaxing music.
A 22-year-old client exhibits memory loss, confusion, and wandering behavior. Which comment by the nurse would provide the best reality orientation for the client when she first awakens in the morning?
Good morning. This is your 2nd day in Memorial Hospital, and I'm your nurse for today. My name is Rachel."
The nurse teaches a client with heart failure to take oral furosemide in the morning. What is the expected outcome for taking this drug in the morning? The client will:
Obtain more sleep.
A primigravid client at 36 weeks' gestation tells the nurse that she has been experiencing insomnia for the past 2 weeks. Which suggestion would be most helpful?
Practice relaxation techniques before bedtime.
A girl in second grade with no remarkable medical history experiences a generalized tonic-clonic seizure in the classroom. Immediately after the seizure, the nurse arrives and notices that the child has been incontinent of urine and is difficult to arouse. Which action would be most appropriate at this time?
Stay with the child, and allow her to sleep in a side-lying position.
The client, who is taking fluoxetine 20 mg at bedtime, tells the nurse the drug is interfering with his sleep. What conclusion should the nurse make?
The client should take fluoxetine in the morning.
The client with dual diagnoses of major depression and alcohol abuse states, "I only drink when I cannot sleep." Which outcome is important for the client to achieve first?
Verbalize the desire to stop drinking alcohol.
The partner of a 22-year-old client dies in a drunk-driving accident. The client complains of difficulty eating, sleeping, and working. The reaction is considered:
a crisis caused by traumatic stress.
The nurse is teaching a client with heart failure how to avoid complications and future hospitalizations. The client has understood the instruction when the client identifies which potential complications? Select all that apply.
becoming increasingly short of breath at rest weight gain of 2 lb (0.9 kg) or more in 1 day having to sleep sitting up in a reclining chair
When assessing a preschooler who has sustained a head trauma, the nurse notes that the child appears to be obtunded. Which finding supports this level of consciousness?
can be roused with stimulation
A client diagnosed with major depression has sleep and appetite disturbances, a flat affect and is withdrawn. The client has been taking fluvoxamine 50 mg twice daily for 5 days. Which client behavior is most important to report to the next shift?
client sleeping from 2300 hours to 0600 hours
The nurse is assessing a client who has a chronic mental illness. What early signs of relapse should the nurse monitor for? Select all that apply
decrease in sleep and self-care increase in social isolation and withdrawal more fears and suspiciousness
An older adult woman who is usually meticulous about her appearance and dress arrives today for her 23rd day of radiation therapy. She appears disheveled and emotionally labile, and her responses to the usual questions are a little inappropriate. Her heart rate is 124 bpm, her respirations are 32 breaths/min, and her skin is cold and clammy. Based on these findings, the nurse should further assess the client for which condition?
delirium
A nurse is caring for a client with panic disorder who has difficulty sleeping. Which nursing intervention would best help the client achieve healthy long-term sleeping habits?
encouraging the client use relaxation exercises
A client requests medication at 9 p.m. (2100) instead of 10 p.m. (2200) so that the client can go to sleep earlier. Which type of nursing intervention is required?
independent
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.
After teaching the mother of a 7-month-old diagnosed with bronchiolitis, the nurse determines that the teaching has been effective when the mother states she will immediately report which sign or symptom?
longer periods of sleep than usual
A mother who gave birth some three hours ago asked the nurse why her baby is so difficult to keep awake. The nurse informs the mother that this behavior indicates
normal progression into the sleep cycle.
The nurse is caring for a client with an exacerbation of ulcerative colitis. The nurse should instruct the client to:
obtain frequent rest periods.
The health care provider (HCP) prescribes pulse assessments through the night for a school- age child with rheumatic fever who has a daytime heart rate of 120 bpm. The nurse explains to the mother that this is to evaluate if the elevated heart rate is caused by which factor?
routine activity during waking hours
A client is scheduled for cardiac catheterization the next morning. The physician ordered temazepam, 30 mg by mouth at bedtime, for sedation. Before administering the drug, the nurse should know that:
sedatives reduce excitement; hypnotics induce sleep.
After administering a prescribed medication to a client who becomes restless at night and has difficulty falling asleep, which nursing action is most appropriate?
sitting quietly with the client at the bedside until the medication takes effect
A nurse is providing care for a pregnant client. The client asks the nurse how she can best deal with her fatigue. The nurse should instruct her to:
try to get more rest by going to bed earlier.