Nurs 1510 Rest/sleep

Front 1

cond. in which the body is in a decreased state of activity, w/ the consequent feeling of being refreshed.

Back 1

rest

Front 2

st. of rest accompanied by altered consciousness and relative inactivity.complex rhythmic st. involving a progression of repeated cycles, rep. diff phases of body and brain activity.

Back 2

sleep

Front 3

urinating in sleep

Back 3

enuresis

Front 4

excessive sleep, esp. during day.

causes:sleep apnea, drug/alcohol, head trauma/cns injury, meds, depression, obesity
even during normal daily routine. disoriented, irritated, restless.

Back 4

hypersomnia

Front 5

may be situational or chronic
diff. falling asleep, intermittent sleep or early awakening from sleep. most common of all sleep disorders

Back 5

insomnia

Front 6

uncontrollable desire to sleep. can fall standing, driving, swimming. neurologic disorder.

begins during teen yrs/early adulthood and continues through life

treatment may include: methylphenidate (ritalin):cns stim.

modafinil (provigil) promotes wakefulness

gamma-hydroxybutyric acid(GHB) sedative to promote nocturnal sleep

Back 6

narcolepsy

Front 7

observed in 10-20% of chronic insomnias. involves marked muscle contractions that result in the jerking of one or both legs during sleep.

Back 7

nocturnal myoclonus

Front 8

periods of apnea or hypopnea between snoring episodes

last 10 sec to 2 minutes

50-600 episodes a night

causes: obstruction, narrowing of nasal passageways

may impair cardiac function over time

Back 8

sleep apnea

Front 9

sleep disorders characterized by insomnia or excessive sleepiness

Back 9

dyssomnia

Front 10

patterns of waking behavior that appear during sleep

Back 10

parasomnia

Front 11

explain NREM stages

Back 11

1: transit state between wakefulness and sleep/ relaxed. 5 % total sleep

2:actual stage of sleep. can be aroused easily. 50-55%

3: depth of sleep increases, arousal harder 10%

4: delta sleep-greatest depth of sleep -10%
slow brain waves. pulse low, metabolism slows, lower body temp

Front 12

explain REM

Back 12

enter from stage 2.
eyes dart back and forth
sm. muscle twitching
lg. muscle immobility, resembles paralysis

irregular or rapid pulse

BP raises, gastric sec. raises, metabolism raises

active brain waves

arousal from sleep hard

20%-25% total sleep

Front 13

how can respiratory disease affect sleep

Back 13

may have trouble breathing, may not be able to relax

Front 14

how can coronary artery disease affect sleep

Back 14

pain assoc. w/ illness, likely felt in rem sleep

Front 15

how can hypertension affect sleep

Back 15

may have trouble relaxing to promote sleep b/c of higher BP.

Front 16

how can hypothryroidism affect sleep

Back 16

lowers amt of NREM sleep, esp. stage 2 & 4

Front 17

excessive urination during night; ppl w/ this might be anxious to go to bed b/c stressed about peeing bed

Back 17

nocturia

Front 18

how does physical illnesss affect sleep

Back 18

a physiologic and psychological stressor, influences sleep. certain illnesses are more closely related to sleep disturbances than others

Front 19

how does current life events affect sleep

Back 19

offshift work, physical exercise and activity promote sleep but don't do it within 2 hrs of going to bed.

alcohol in moderation induces sleep.

exvessive amts of alcohol limit rem and delta sleep.

caffine stim.

smoking stim.

Front 20

how does emotional and mental status affect sleep

Back 20

psychological stress: lowers amt of sleep/lowers rem sleep

any life situations/illness that cause stress tend to disturb sleep. either lower amt of of time sleeps or lowers amt of rem sleep (anxiety, stress)

Front 21

how does bedtime routines interfere w/ sleep

Back 21

most ppl have them to help relax and promote sleep. reading, radio, tv, chatting, personal hygiene.

Front 22

how does bedtime environment affect sleep

Back 22

most ppl sleep best in home environment. sleeping in a new/strange place influences sleep. if used to a certain noise and now absent may be harder to fall asleep.

Front 23

What controls the cyclic nature of sleep

Back 23

the RAS and bulbar synchronizing region work together (brainstem)

Front 24

inner clock- complete cycle every 24
some monthly

reg. certain biologic and behavioral function

Back 24

circadian rhythms

Front 25

physiology of sleep

Back 25

-circadian rhythm:inner clock
-brainstem: RAS and bulbar sych. region work together
-nerurotransmitters: are involved. norepinephrine, acetylcholine, dopamine, serotonin, histamine, GABA

Front 26

extends upward through medulla, pons, midbrain and into hypothalamus

-facilitates reflex and voluntary movements and cortical activities r/t a st. of alterness.

Back 26

RAS

Front 27

functions that depend on circardian rhythms

Back 27

heart rate, blood pressure, body temp, hormone sec., metabolism, performance and mood

Front 28

2 major stages of sleep

Back 28

nrem and rem

Front 29

EEG

Back 29

electroencephalograph- rec. and receives electrical currents from brain.

Front 30

EOG

Back 30

elctrooculogram- rec. eye movement

Front 31

EMG

Back 31

rec. muscle tone

Front 32

nrem represents what total % of sleep

Back 32

75%

Front 33

throught nrem sleep, vital signs...

Back 33

decrease. parasymth N S dominates

Front 34

throught rem sleep, vital signs...

Back 34

increase. general muscle tone and deep tendon reflexes are depressed.

Front 35

sleep cycle

Back 35

lasts 90 minutes
80 min nrem
10 min rem

4-5 cycles per night

Front 36

the average adult gets how much sleep

Back 36

7-9 hrs/night

Front 37

motivation-how it affects sleep

Back 37

no matter how tired, if motivated can stay awake

minimal motivation-fall asleep

Front 38

how does carbs affect sleep

Back 38

affect serotonin levels, calmness and relaxation

Front 39

how does sleep affect peptic ulcer disease (PUD

Back 39

gastric sec are higher during rem

awaken at night w/ pain, eating a snack or antacids often helps

Front 40

How does sleep affect CAD/MI

Back 40

pain likely during rem sleep

Front 41

how does sleep affect seizures

Back 41

occur during nrem and depressed during rem

Front 42

how does sleep affect liver failure/encephalitis

Back 42

cause reversal in night/day sleeping habits

Front 43

how does sleep affect ESRD

Back 43

disrupts nocturnal sleep; leads to excessive daytime sleepiness

Front 44

barbiturates, amphetamines and antidepressants do what to sleep

Back 44

decrease amt of rem sleep

Front 45

diuretics does what to sleep

Back 45

nocturia

Front 46

narcotis do what to sleep

Back 46

suppress ren

Front 47

cardiac meds do what to sleep

Back 47

nightmares, insomnia

Front 48

sleep meds

Back 48

short term use
zaleplon, zolpidem amd artrate (ambien)

Front 49

4 categories of sleep disorders

Back 49

dyssomnias
parasomnias
sleep dis. assoc. w/ medical or psychiatric disorder, other proposed disorders

Front 50

characterized by insomnia or excessive sleepiness

-insomnia
-hypersomnia
-narcolepsy
-sleep apnea
-restless leg syndrome
-sleep deprivation

Back 50

dyssomnias

Front 51

patterns of waking behavior during sleep

Back 51

parasomnias

Front 52

creeping, crawling, tingling sensations in legs

treatments: elim. caffeine, tobacco, alcohol

mild analgesic at bedtime
heat/cold compress
-relaxation techniques
-ropinirole (requip)

Back 52

restless leg syndrome

Front 53

patterns of waking beh. during sleep
somnambulism: sleep walking
sleeptalking
night terrors-trauma, fears, anxiety
bruxism-grinding teeth
enuresis
sleep-related eating disorder

Back 53

parasomnias

Front 54

nursing diagnoses for sleep

Back 54

disturbed sleep pattern
anxiety
activity intolerance
fatigue
impaired gas exchange
risk for injury
deficient knowledge
dirturbed thought processes

Front 55

nursing interventions

Back 55

assessment
environmental controls
promote bedtime rituals
promote comfort
promote activity
respect normal sleep-wake pattens
pharmacological aids
teaching
OSA, surgery, CPAP