Pathophysiology chap 17

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 nurse is obtaining a client's sleep history. The client asks about obtaining a prescription for melatonin. What is the nurse's best response?

"Melatonin is available without a prescription, but speak to your health care provider about it."

Place the following characteristics of stages of sleep in the order they occur when a client progresses from stage 1 to stage 4 sleep, with rapid eye movement (REM) sleep occurring after stage 4. Use all options.

1.During this stage, people can be easily aroused. 2.This stage lasts approximately 10 to 25 minutes, during which 3.EEG activity includes predominantly theta waves. 4.This stage lasts only a few minutes, leading to deeper sleep. 5.The deepest sleep occurs during this stage. 6.The brain is highly active with vivid dreams occurring.

At what age is an infant typically able to sleep through the night and have consistent nap times?

9 months

What is the length of time a client undergoes a complete sleep cycle?

90-110 minutes

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 who is hospitalized in the intensive care unit after having a myocardial infarction (MI) informs the nurse that he needs a sleeping pill because of the inability to sleep in that environment. The client states that he has never had trouble sleeping before. Which type of insomnia does the nurse recognize the client is having?

Acute insomnia

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

Alzheimer disease

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 caring for a client in the intensive care unit who has been unable to sleep well for days. Which symptoms may be associated with sleep deprivation? Select all that apply

Anxiety Irritability Inability to concentrate

A school nurse is presenting a "Healthy Adolescent" class for parents. The focus of the class is to support parental understanding of how the lack of adequate sleep affects their children in the academic setting. The nurse shares with the parents that lack of proper sleep causes which symptoms? Select all that apply.

Decline in cognition Degrees of irritability Difficulty with anxiety

A parent brings a 15-year-old adolescent into the clinic, stating "I cannot wake him up in the morning. He has been late for school several times and I do not know what to do any longer." Which sleep syndrome is the nurse aware is common in adolescents?

Delayed sleep phase syndrome (DSPS)

The nurse is teaching a client with restless legs syndrome (RLS) about potential interventions. Which interventions will the nurse include? Select all that apply.

Dopaminergic medications Physical activity Muscle massage Improved sleep hygiene

A nurse is discussing sleep hygiene with a client who reports having chronic insomnia. Which are appropriate recommendations? Select all that apply.

Establish a regular wakeup time. Maintain a quiet sleep environment that is neither too cold nor too hot. Avoid caffeinated beverages.

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

A parent informs the nurse that their family was on vacation, staying in a hotel, and woke up to the sound of a knock at the door. When they opened the door, their 8-year-old child was standing at the door not knowing where he was. This was not the first occurrence of sleepwalking for this child. Which objective should be the priority concern?

Injury during an episode of sleepwalking

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.

The nurse has a client who appears to be sleepwalking. Which intervention would be most appropriate for the nurse?

Lead the client back to bed.

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

The client states having periods of being "unaware of surroundings" and "falling asleep during the day." The client is scheduled for an electroencephalogram (EEG) to determine if there is seizure activity or a sleep disturbance. What will the nurse teach the client about the purpose of the EEG?

Measuring the combined activity among neurons to a given stimulus

A nurse is caring for a client who weighs 325 pounds. The client's spouse reports that the client snores loudly and stops breathing frequently when sleeping. For which possibly related symptom will the nurse assess?

Morning headaches

The spouse of a blind client calls the nurse practitioner to ask what is causing the client such a difficult time sleeping and what can be done. What might the client be suffering from, and which would be the most accurate response?

Non-24 hour sleep-wake syndrome; regulate wake and sleep times.

The nurse practitioner is examining a client who delivered a healthy baby 2 weeks prior to the visit. The client is complaining of severe mood swings, anxiety, and just feeling down overall. The nurse practitioner asks the client about frequency and duration of sleep disturbances in an effort to determine interruption in which sleep stage?

REM

Which sleep stage is characterized by an increase in brain activity?

REM sleep

In which stage of sleep does dreaming occur most frequently?

Rapid eye movement sleep

Sleepwalking can occur in both adults and children. Typically, what does someone who is sleepwalking do?

Refuse to respond to communication efforts of other people

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

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

Sleep terrors

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

A person with advanced sleep phase syndrome (ASPS) would likely display which symptoms?

Trouble staying awake in the evening and waking up early in the morning feeling rested

The nurse is caring for a client who has been diagnosed with narcolepsy. The client reports that his muscles become extremely weak when he becomes excited. The nurse understands that the client is describing which of the following?

cataplexy

A nurse has just returned to her home on the East Coast of the United States after attending a nursing conference on the West Coast. Which symptoms are related to circadian rhythm and may be experienced by the nurse? Select all that apply.

insomnia Daytime sleepiness Decreased alertness and performance

A client's primary care provider has recommended a melatonin supplement. The use of this supplement will produce:

phase-shifting changes in the circadian rhythm, similar to those caused by light.