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Sleep

Sleep . Chapter42. Sleep Basics. Sleep contributes to healing & tissue repair Human Growth Hormone released Protein synthesis, cell division Brain tissue repair May help us process information and experiences [learning] REM sleep During sleep, HR, RR, B/P decrease

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Sleep

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  1. Sleep Chapter42 NRS_105/320_Collings

  2. Sleep Basics • Sleep contributes to healing & tissue repair • Human Growth Hormone released • Protein synthesis, cell division • Brain tissue repair • May help us process information and experiences [learning] • REM sleep • During sleep, HR, RR, B/P decrease • Muscles relax [paralysis during deep sleep] NRS_105/320_Collings

  3. Factors Influencing sleep • Anything that causes pain, anxiety, discomfort [e.g. full bladder] interferes with sleep • Hospitalization, illness, anxiety, pain= poor sleep • Respiratory disease – may need head up • Nocturia – disrupts sleep • Environment • Noise, smells, light levels, interruptions common in healthcare facilities • Sleeping alone NRS_105/320_Collings

  4. Factors Influencing sleep • Medications – • may interfere with REM, sleep cycle, or cause side effects [e.g. flushing, vivid dreaming] that disrupt sleep • Lifestyle – changes in sleep/work/play pattern • Shift work, social activities • To adjust body clock, stay on schedule [weeks] • Emotional Stress • Exercise & fatigue – effect R/T type • Fatigue R/T exercise promotes sleep • Fatigue r/T stress inhibits sleep • Food intake: indigestion, caffeine/stimulants • Alcohol causes early sleep then waking • Hunger makes it hard to sleep NRS_105/320_Collings

  5. Baseline sleep Patterns • Infants – sleep 12-16 hours a day • Toddlers – School Age children: sleep time decreases with age; 12 – 10 hrs needed • Adolescents – may need much more sleep than they get [7 hrs] leading to poor concentration • Young adult: need 6-9 hours to function at peak • Middle Age: Deep sleep declines, emotional and physical issues may cause insomnia • Older adults: > 50% have sleep problems R/T physical illness/pain/nocturia. May increase confusion during daytime and at night NRS_105/320_Collings

  6. Sleep Disorders • Sleep apnea • Obstructive type most common • Client may not be aware of waking • Usually SO c/o snoring • Causes impairment during waking hours, cardiac prob, increases risk of HTN, stroke, sexual dysfunction… • Anesthesia causes temporary obstructive sleep apnea – monitor and position [not supine] • Insomnia • Difficulty falling asleep • Frequent waking or trouble falling back to sleep • Sleep deprivation • Chronic lack of sleep [nurses, students, patients] NRS_105/320_Collings

  7. Assessment • Usual sleep patterns • Recent changes • Describe a typical night…. [open ended] • S/SX – snoring, problems falling asleep /staying asleep/waking • Effect & Severity – impact on function, interaction, concentration • Contributing factors [meds, intake, exercise, illness, etc.] • Usual routine at bedtime/environment NRS_105/320_Collings

  8. Nursing diagnoses • Ineffective breathing pattern R/T obstruction of airway 2* to sleep apnea AEB snoring, daytime drowsiness • Ineffective Role Performance R/T poor concentration 2* to lack of sleep AEB decline in grades, falling asleep in class • Risk for injury R/T daytime drowsiness • Confusion r/t chronic lack of sleep AEB LOC, forgetfullness NRS_105/320_Collings

  9. Goals • Work with client to develop goal • Overall: improve sleep pattern/ improve daytime functioning • Client will verbalize satisfaction with quality of rest/sleep while hospitalized • Pt will demonstrate improved sleep pattern by napping less than 1 hour/day by end of week • Client will demonstrate proper use of CPAP for sleep apnea by end of visit today NRS_105/320_Collings

  10. Interventions • Promote client control, information to decrease stress • Promote usual sleep patterns • Bedtime, routine • Control environment and interruptions • Within ability • Control Pain • position of comfort, massage, shower, pillows/position • Promote safety • Night light or bathroom light in unfamiliar room • Medications • Best for acute/short term use only NRS_105/320_Collings

  11. Evaluation • Client is best source for evaluating • Did client verbalize good/improved rest? • Does client nap less next day? • Is client behavior different? • Goal met? • Revise or continue with plan NRS_105/320_Collings

  12. Try it • Do you have good sleep habits? • Write a care plan for yourself or another/ hypothetical student • You may use a patient, friend, or case study if you prefer • This may be your self-care plan NRS_105/320_Collings

  13. Questions? NRS_105/320_Collings

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