davis edge questions sleep and rest

A 36-year-old male has been admitted to the medical-surgical floor for 24-hour observation due to exhaustion. The client reports difficultly falling asleep and then staying asleep for the past 5 months when he started a new job working nights. In addition, he states that since his 5th child was born, it is loud in his house, causing him to not get restful sleep when he gets home from work. He states he often works 12- to 14-hour shifts and only gets about 4 hours of sleep before having to return to work, and frequently dozes off on the job. He came to the hospital because he thinks he has "narcolepsy or something." Upon further assessment, he reports being very agitated at the slightest things and that he and his wife have been fighting a lot, and the nurse notices he looks very tired with dark circles underneath his eyes. What is the objective data in this scenario that help form the nursing care plan? Select all that apply.

Admitted for exhaustion Looks tired with dark circles under the eyes

Breakfast is brought to a client who has been experiencing severe pain and thus little sleep. He or she is finally able to sleep due to analgesic therapy and is asleep when the tray is brought into the room. What should the nurse do in this situation?

Allow the client to sleep and have the breakfast tray brought later in the morning.

A client presents to the clinic requesting medication to help him or her sleep. The health-care provider diagnoses the client with insomnia. Which criteria would the nurse expect to be present related to this diagnosis?

Happens three days per week Happens for at least three months

The nurse is developing a plan of care for a client in the intensive care unit with fluid volume overload related to congestive heart failure who is receiving diuretics. Which factors can lead to altered sleep patterns for this client?

Hospitalization in an intensive care unit Frequent urination related to diuretic use Repeated interruptions throughout the day and night

A client is concerned about having narcolepsy, as he or she has sudden involuntary episodes of sleep occurring at random times during the day. What questions should the nurse ask to further investigate the client's concern?

How have your sleeping patterns been lately? Have you experienced any slurred speech or changes in your facial muscles prior to these episodes? Do you feel numbness, weakness, or unusual feelings in your knees or legs? Have you recently changed shifts at work?

Which part of the brain controls circadian rhythms?

Hypothalamus

In which sleep stage would a client's EEG show beta waves?

In periods of wakefulness

The nurse is educating a group of teenagers regarding obtaining sufficient amounts of sleep. Which consequences of sleep deprivation should the nurse include in the presentation?

Increases sensitivity to pain Intensifies insulin resistance increases appetite and intake

A 38-year-old healthy woman is being seen for her physical examination and Pap smear. During assessment, she states she lies in bed awake for hours before falling asleep and often wakes in the middle of the night and can't go back to sleep. She also states she feels exhausted in the morning and is tired all the time. She admits to feelings of irritability toward others and lack of desire to engage in social activities because she's "just too tired." What would an appropriate nursing diagnosis be for this client?

Insomnia

A client who has just changed to working third shift is concerned about getting enough sleep. What is the probable cause for this?

Interrupted circadian rhythm

The nurse is assessing the sleep-wake pattern of a client admitted to the hospital with a gastrointestinal bleed. Which findings would require a more in-depth sleep evaluation?

Lasts for longer than 30 days Wakes up four times per night

The nurse is working with a client newly diagnosed with narcolepsy. Which treatment regimen would the nurse expect to be prescribed for this client?

Methylphenidate (Ritalin)

The nurse is caring for a client with uncontrolled type 1 diabetes mellitus and is experiencing varying blood glucose levels. Which nursing intervention should the nurse perform that may prevent sleep and rest for the client?

Monitor blood glucose levels during the night.

Which changes can be noted during the deepest stage of non-REM sleep?

Muscles relax. Heart rate lowers. Respirations decrease.

Which is the restful phase of sleep in which physiological function is slow?

NREM

A preoperative client has not been sleeping well for years but is having even more difficulty lately due to worry about the procedure and concern about being able to receive Ambien while in the hospital. The client states, "I really can't sleep at all without it," and has been taking the medication for several years. Even though the client will receive opioid analgesics postoperatively, the physician still prescribes Ambien. What could be the reason behind this decision?

Pain can cause sleep disturbances.

The parents of a toddler report difficulty getting their child to sleep at night. The child wants to play and not go to sleep. Which intervention suggested by the nurse would be most effective?

Plan sedentary activities the last hour before bed.

A client is about to engage in a sleep study to determine sleep apnea. At which stage would an EEG show vivid dream activity?

REM

What priority nursing intervention does the nurse incorporate into a plan of care to promote sleep for a hospitalized client?

Schedule nursing care to avoid interrupting sleep.

An adolescent reports constant fatigue and an inability to stay awake in school. Which factors should the nurse assess for that could be interfering with sleep?

Smart phone use Drug and alcohol use Caffeine consumption school work and studying

Which factors can affect geriatric clients' ability to obtain adequate sleep at night?

Taking longer to fall asleep Awakening for longer periods during the night Nocturia interfering with sleep

A 38-year-old client is asking for medication for trouble falling asleep and staying asleep. The client also feels groggy and unrested during the day. What should the nurse assess for as possible etiologies?

Watching TV while in bed Sleeping with smart phone nearby Caffeine consumption Current medications

When assessing a client for sleep disturbances, what is an appropriate question to address the sleeping environment?

What room temperature do you prefer?

Which intervention can the nurse include in the plan of care for a client in the hospital to promote sleep and rest?

clustering activities

Which sleep disorders are considered secondary and are caused by underlying health disorders?

pain, depression, hyperthyroidism

Which diagnostic test involves measuring brain wave activity, oxygen and carbon dioxide levels, and vital signs?

polysomnography

Which high-amplitude brain waves found during sleep are common in children but rare in adults?

theta

A client who has depression with secondary insomnia is requesting "some kind of relief" to improve his or her quality of life. What type of medication would most likely be prescribed for this client?

tricyclic antidepressant

What questions would best address sleep changes and problems when assessing a client's sleep history?

How often do you experience difficulty falling asleep? Do you ever experience an unpleasant creeping feeling, crawling, or tingling, relieved only by moving the legs at night? Do you snore? Do you grind your teeth while you sleep?

What is the benefit of the nurse providing a back massage instead of delegating it to a NAP?

It allows fostering of the nurse-client relationship while assessing client needs.

Which sleep disorder involves a person suddenly waking up thrashing about and hallucinating?

Night terrors

Which neurotransmitters are related to excitatory and inhibitory sleep mechanisms?

Serotonin Histamine Prostaglandins Acetylcholine