Download Chapter 41 Rest and Sleep Study Questions

Chapter 41 Rest and Sleep Study Questions
1. Define, rest, relaxation and sleep.
2. Discuss the physiology of sleep including:
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Circadian rhythms
 Define circadian rhythm, biorhythm, and ultradian rhythm
Stages of sleep
 REM sleep: what characterizes REM sleep? % sleep time? Changes
in vital signs, muscle activity, metablolic rate, brain activity?
Compare to nonREM sleep.
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Non-REM sleep
 Stage I
 Stage II
 Stage III
 Stage IV
 When are you the most difficult to arouse?
 Describe the typical sleep cycle. When do you
lose most
REM sleep if awakened? What is the effect of decrease in
metabolic rate with sleep? Why does NREM sleep decrease
with age?
 What is the benefit of REM sleep? What is the function of
melatonin?
3. Discuss factors that affect sleep. (pay most attention to effects of smoking and
changes with aging.
4. Discuss common sleep disturbances and compare their signs and symptoms:
5.
o Insomnia
o Sleep apnea
o Narcolepsy
o Sleep deprivation
Identify nursing diagnosis that apply to the patient experiencing sleep
disturbances. Be able to recognize the characteristics of Sleep pattern disturbance
and Fatigue; understand why the related nursing diagnoses might coexist.
6. Identify goals/outcomes that apply to the patient experiencing sleep
disturbances. Recognize outcomes for each diagnosis. Distinguish between the
outcomes that indicate resolution (goal is met) of the diagnosis and those that are
intermediate (i.e., show progress toward the goal).
7. Explain nursing interventions for the patient experiencing sleep disturbances
that assist the patient toward health promotion, restoration and maintenance.
o Drug therapy pg 1146
 sedative/hypnotic agents (what is the advantage of zolpidem over
benzodiazepine); why are barbiturates no longer used?
antianxiety agents : benzodiazapines (Ativan, Valium,etc) Why
are these only used for short periods; what are the after effects?
What is the effect of drug therapy on the stages of sleep? Almost any
medication that increases sleep deprives you of REM sleep; look under
sleep deprivation and see what effects this would have.
Be very familiar with the Bootzin technique.
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Identify relaxation techniques. The effects of massage.
What is the rationale for taking medication before bedtime, rather than
waiting until you can’t sleep?
What is rumination and how do you use cognitive strategies to prevent it
from disturbing the ability to fall asleep?
Discuss evaluation and modification of interventions based on the individual client's
response.