Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
34 Cards in this Set
- Front
- Back
|
NREM sleep
|
Occurs when activity in RAS inhibited.
75% to 80% of sleep Consists of 4 stages |
|
|
NREM sleep Stage 1
|
Only a few minutes
feels drowsy and relaxed eyes roll from side to side HR & RR drop slightly Can be readily awakened |
|
|
NREM sleep Stage 2
|
Light sleep
Lasts 10 - 15 minutes Eyes generally still HR & RR decrease slightly Body temp falls 44 - 55% of total sleep Requires more intense stimuli to awaken |
|
|
NREM sleep Stage 3
|
Deepest stage of sleep
HR & RR drop 20 - 30% Skeletal muscles very relaxed Reflexes are diminished Swallowing & saliva Prod. reduced Essential for restoring energy and releasing imp. hormones Difficult to arouse |
|
|
Physiologic Changes in NREM sleep
|
BP falls
Pulse rate decreases Peripheral blood vessels dilate CO decreases Skeletal muscles relax GH levels peak BMR decreases Intracranial pressure decreases |
|
|
REM sleep
|
Occurs every 90 minutes
Lasts 5 - 10 min. Acetylcholine & dopamine inc. dreaming takes place Brain highly active Brain Metab. increases Distinctive eye mvmt occur Vol. muscle tone dram. decr. Difficult to arouse HR & RR irreg. |
|
|
Sleep patterns
|
Infants: 3-4 hours, eat, sleep
Toddlers: 12 - 14, naps PS: 11 - 13 School-age: 10 - 11 Adolescents: 9 - 10 Adults: 7 - 9 |
|
|
Factors that affect sleep
|
Illness
Environment Lifestyle Emotional Stress Stimulants and alcohol Diet Smoking Motivation Meds. |
|
|
Sleep Disorders
|
Insomnia: Can't sleep
Excessive daytime sleepiness Parasomnias: |
|
|
Insomnia
|
Difficulty falling asleep
Difficulty staying asleep Irritability (Older age, females) |
|
|
Excessive Daytime Sleepiness
|
Hypersomnia
Narcolepsy Sleep apnea Insufficient sleep |
|
|
Excessive Daytime Sleepiness
|
Hypersomnia
Narcolepsy Sleep apnea Insufficient sleep |
|
|
Hypersomnia
|
Sufficient sleep at night but cannot stay awake during the day
-Caused by Med. or Psych disor. -CNS, diabetes, kidney probs. |
|
|
Narcolepsy
|
Caused by lack of hypocretin in CNS that reg. sleep
Clients have sleep attacks Sleep at night begins w/sleep onset REM period |
|
|
Sleep Apnea
|
Frequent short breathing pauses during the night:
-More than 5 apneic ep.> 10sec/hr considered abnormal |
|
|
Hypersomnia
|
Sufficient sleep at night but cannot stay awake during the day
-Caused by Med. or Psych disor. -CNS, diabetes, kidney probs. |
|
|
Parasomnia
|
Behavior that may interfere w/or occur during sleep
-ie: sleepwalking, talking, sleep terrors, Nightmares, Bruxism |
|
|
Narcolepsy
|
Caused by lack of hypocretin in CNS that reg. sleep
Clients have sleep attacks Sleep at night begins w/sleep onset REM period |
|
|
Sleep Assessment
|
Sleep History
-When do you go to sleep? -Bedtime rituals? -Do you snore? -Can you stay awake in AM? -Taking Meds? |
|
|
Sleep Apnea
|
Frequent short breathing pauses during the night:
-More than 5 apneic ep.> 10sec/hr considered abnormal |
|
|
Physical Exam for Sleep history
|
Rarely yields info. unless OSA
-Enlarged/reddened uvula -Enlarged adenoids/tonsils -Obesity -Neck circ. >17.4 (men) -Deviated septum |
|
|
Parasomnia
|
Behavior that may interfere w/or occur during sleep
-ie: sleepwalking, talking, sleep terrors, Nightmares, Bruxism |
|
|
Sleep Diary
|
Keep track of
-Time factors assoc. w/sleep -Activity 2-3 hrs B4 sleep -Caffiene, alcohol -Meds -Bedtime rituals -Daytime sleepiness -Worries or fears |
|
|
Sleep Assessment
|
Sleep History
-When do you go to sleep? -Bedtime rituals? -Do you snore? -Can you stay awake in AM? -Taking Meds? |
|
|
Diagnostic Studies
|
Polysomnography
-EEG -brain waves -EMG - records face muscles -EOG - records eye movement |
|
|
Diagnoses
|
Disturbed Sleep Pattern
-"difficulty falling asleep" or "difficulty staying asleep" Sleep Pattern Disturbances -Risk for injury -Ineffective coping -Fatigue -Risk for impaired gas exch -Anxiety -Activity intolerance |
|
|
Physical Exam for Sleep history
|
Rarely yields info. unless OSA
-Enlarged/reddened uvula -Enlarged adenoids/tonsils -Obesity -Neck circ. >17.4 (men) -Deviated septum |
|
|
Sleep Diary
|
Keep track of
-Time factors assoc. w/sleep -Activity 2-3 hrs B4 sleep -Caffiene, alcohol -Meds -Bedtime rituals -Daytime sleepiness -Worries or fears |
|
|
Diagnostic Studies
|
Polysomnography
-EEG -brain waves -EMG - records face muscles -EOG - records eye movement |
|
|
Diagnoses
|
Disturbed Sleep Pattern
-"difficulty falling asleep" or "difficulty staying asleep" Sleep Pattern Disturbances -Risk for injury -Ineffective coping -Fatigue -Risk for impaired gas exch -Anxiety -Activity intolerance |
|
|
Sleep Nursing Outcomes
|
-Maintain a sleeping pattern that provides sufficient energy for daily activities
-Enhance feeling of well being -improve the quality/quantity of the client's sleep |
|
|
Sleep Nursing Interventions
|
-Reduce Envir. distractions
Control temp, noise, lighting -Promote bedtime rituals -Provide Comfort measures -Sch. nursing care to promote uninterrupted sleep -Teach stress red., relax tech. |
|
|
Medications
|
Sedative-hypnotics (induce sleep) (depress the cns)
Anti-anxiety or tranquilizers |
|
|
Medications
|
Non-benzodiazepines
Benzodiazepines |
