NURS 201: Week 10 - Sleep & Rest/Teaching & Learning
Caffeinated beverages should be limited to how many per day to aide in sleep?
1 or 2 a day and none in the evening
Benzodiazepines half life
20-100 hours
How many stages of nonrapid eye movement (NERM) sleep?
3 stages
length of sleep cycle
90-100 minutes
Parasomnias
Abnormal behaviors such as nightmares or sleepwalking occur during sleep. Somnambulism, Night terrors, Nightmares, Nocturnal enuresis (bed-wetting) More common with Children, Bruxism.
Circadian disorders
Abnormality in sleep/wake times Caused by rapid time-zone changes (jet lag), shiftwork (night shift), or change in total sleep time from day to day.
Obstructive sleep apnea (OSA) risk factors
Age Obesity Male
Teaching
An interactive process that promotes learning.
How can nurses help motivate?
Assess patient's feelings When will they be able to utilize what you are teaching? Give feedback
nursing process (ADPIE)
Assessment Diagnosis Planning Implementation Evaluation
A 4-year-old pediatric patient resists going to sleep. To assist this patient, the best action to take would be: A. adding a daytime nap. B. allowing the child to sleep longer in the morning. C. maintaining the child's home sleep routine. D. offering the child a bedtime snack.Quick Quiz!
C
Nurses must possess the knowledge and skills needed for patient teaching so that A. They can complete the documentation forms related to client teaching accurately. B. They can help the hospital meet The Joint Commission standards requiring client teaching. C. They can promote the health, safety, and rights of clients through education. D. They can meet the patient rights delineated in the "Patient Care Partnership."
C
Restless Leg Syndrome (RLS)
CNS disorder characterized by uncontrollable movement of legs while resting or before sleep onset
Mixed apnea
CSA and OSA
herbs that promote sleep
Chamomile, lavender, valerian root
Insomnia
Chronic inability to fall asleep, remain asleep, or go back to sleep. Frequent awakenings, daytime drowsiness Occurs at least 3 nights/wk for 3 months or longer.
parts to cognitive knowledge
Comprehension Application Analysis Synthesis Evaluation
sleep
Cyclical states/altered consciousness Decreased motor activity/perception Selective response to external stimuli
During rounds on the night shift, you note that a patient stops breathing for 15 to 20 seconds several times during the shift. This condition is known as: A. cataplexy. B. insomnia. C. narcolepsy. D. sleep apnea.
D
Central Sleep Apnea (CSA) causes
Dysfunction of respiratory control center = CNS Prematurity Brainstem injury- head trauma Medications- opioids, tranquilizers Problems affecting the brainstem- infection, stroke
sleep deprivation causes
Emotional stress, Medications, Environmental disturbances, Symptoms
(T/F) Most health-related lifestyle behaviors are inherently enjoyable and intrinsically motivated.
False
Tips for Adult learners
Identify their own learning needs Why it is important Teach close to time they use it Partner with your patient Discuss "Need to Knows"
Benefits of sleep
Increases mental performance by improving learning and storing long-term memory Repair Energy Reduces stress/anxiety, improves ability to cope Strengthens immune system
Adult learners attitudes
Independent & self directed Recognize need before willingness to learn More motivated if able to apply immediately Prefer to be partners in the learning process May be resistant to learn
Circadian rhythm
Internal clock, 24-hour day/night sleep/wake pattern Rhythm of sleep frequently becomes synchronized with other body functions. Affected by light, temperature, social activities, and work routines.
rest
Mild to no activity Relaxation; stress free Refreshing
What is the #1 factor affecting learning?
Motivation
Factors That Affect Learning
Motivation/Readiness/Developmental Stage/Complexity Timing/Environment/Scheduling Active Involvement Feedback/Communication Repetition
sleep medications
Nonbenzodiazepines Benzodiazepines Barbiturates Selective melatonin agonists Tricyclic antidepressants Nonprescription sleep meds (Antihistamines, Melatonin, Herbs)
most common type of sleep apnea
OSA
Why nurses teach
Patients and nurses are involved in shared decision making Hospital stays are brief Healthcare is expensive
sleep apnea
Periodic breathing cessation for at least 10 sec during sleep
4 phases of sleep
REM NREM-1 NREM-2 NREM-3
REM sleep
Rapid eye movement sleep Vivid dreams commonly occur
Reticular activating system (RAS)
Responsible for maintaining wakefulness
sleep history
Sleep log for 14 days Description of sleeping problems, current life events, physical and psychological illness, emotional and mental status, behaviors of sleep deprivation
SMART goals
Specific, Measurable, Attainable, Relevant, Time sensitive
Learning
The purposeful acquisition of new knowledge, attitudes, behaviors, and skills.
Nonbenzodiazepines examples
Zolpidem tartrate Zaleplon
drugs that influence sleep
Zolpidem tartrate, hypnotics, diuretics, opioids, antidepressants, alcohol, caffeine, beta-blockers, anticonvulsants
Psychomotor (Skills)
acquiring skills that require mental and muscular activity
EEG alpha waves???????????????????
awake but relaxed
Reticular activating system (RAS) location
brain stem
The nurse has assessed the patient and has created a teaching plan. The nurse is worried about the patient being compliant. What is a predominant factor that the nurse should consider? a. Financial b. culture c. motivation d. time
c
3 domains of learning
cognitive affective psychomotor
The nurse is evaluating the responses of clients to teaching sessions. An example of an evaluation of a psychomotor skill is: a. client is able to state side effects of medication b. client responds appropriately to eye contact c. client planned an exercise program d. client uses the cane correctly
d
Benzodiazepines examples
diazepam lorazepam triazolam alprazolam flurazepam
Hypersomnia
excessive sleeping, especially in the daytime.
Affective (feelings)
expression of feelings and acceptance of attitudes, opinions, or values Receiving Characterizing
controls circadian rhythm
hypothalamus
Cognitive (Thinking)
includes all intellectual behaviors and requires thinking
Most common sleep disorder
insomnia
sleep deprivation
lack of sleep
Obstructive sleep apnea (OSA) treatment
lifestyle changes (weight loss), use of a breathing assistance device at night (continuous positive airway pressure - CPAP)
OSA
obstructive sleep apnea
Electroencephalogram (EEG)
record of the electrical activity of the brain
somnambulism
sleepwalking
Obstructive sleep apnea (OSA) symptoms
snoring loudlyand feeling tired even after a fullnight's sleep
cataplexy
sudden loss of muscle control
Narcolepsy
uncontrollable sleep attacks
Barbiturates
•Deprive people of REM Sleep •Life threatening breathing problems
Benzodiazepines
►Long acting ►May cause daytime sleepiness ►Seizures
Nonbenzodiazepines
►Shorter Half-life ►Doesn't cause Daytime sleepiness ►Ambien half life 2 hours