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SLEEP, REST AND COMFORT. Bedtime fears, wakefulness during the night, and nightmares are associated with which of the following age groups. Infants Toddlers Preschoolers school-age children. Which of the following medications may create sleep disturbance?. Antihistamine Narcotic

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Bedtime fears, wakefulness during the night, and nightmares are associated with which of the following age groups

  • Infants

  • Toddlers

  • Preschoolers

  • school-age children


Which of the following medications may create sleep disturbance
Which of the following medications may create sleep disturbance?

  • Antihistamine

  • Narcotic

  • Beta-blocker

  • antidepressant


The client while sitting up at 3 00am tells you she cannot sleep what should the nurse do first
The client, while sitting up at 3:00AM, tells you she cannot sleep. What should the nurse do first?

  • Assist the client back to bed

  • Obtain an order for a hypnotic

  • Provide a glass of warm milk and back rub

  • Ask about

    activities that have helped the client in the pastto sleep.


It is commonly believed that the average person requires
It is commonly believed that the average person requires sleep. What should the nurse do first?

  • 6 hours sleep

  • 7 hours sleep

  • 8 hours sleep

  • More than 8 hours sleep


Physiology of sleep
PHYSIOLOGY OF SLEEP sleep. What should the nurse do first?

  • State of altered consciousness

  • Slowing of the body’s physiological processes.

  • Stages of sleep/ 2 categories

  • NREM-non-rapid eye movement/90 min.

  • REM- rapid eye movement-80% dreams

  • Sleep cycle- 70-90 minutes


Sleep regulation
SLEEP REGULATION sleep. What should the nurse do first?

  • Biological clock/Circadian rhythms

  • Reticular Activating System

  • Stimuli: visual, auditory, pain, tactile

  • Emotions and Thoughts

  • Norepinephrine and Serotonin

  • Diet, drugs, and other substances

  • Life Span considerations


Sleep assessment
SLEEP ASSESSMENT sleep. What should the nurse do first?

  • Nature, quality, routines , environment

  • Associated factors and own opinion

  • Alleviating factors/ WHAT WORKS!

  • Effect of problem on Client

  • Disturbed Sleep Pattern (NANDA)

  • Cultural considerations


Sleep disorders
SLEEP DISORDERS sleep. What should the nurse do first?

  • Alteration in sleep patterns/sleep pattern disturbance (page 291, fund. book)

  • Insomnia

  • Hypersomnia

  • Parasomnia

  • Narcolepsy

  • Sleep Apnea

  • Sleep Deprivation


Managing sleep disturbance
MANAGING SLEEP DISTURBANCE sleep. What should the nurse do first?

  • Communication techniques

  • Sleep environment

  • Complementary and alternative modalities

  • Dietary guidelines and dietary aids

  • Relaxation techniques and activities


Drug interventions
DRUG INTERVENTIONS sleep. What should the nurse do first?

  • Tricyclic Antidepressants- amitriptyline (Elavil) and doxepin (Sinequan)

  • Antihistamines- hydroxyzine (Vistaril, Atarax), and diphenhydramine (Benadryl)

  • Herbal and Vitamin preparations

    Melatonin, Chamomile, Passion flower, Kava kava


Sedative hypnotic meds
SEDATIVE-HYPNOTIC MEDS sleep. What should the nurse do first?

  • Sedative agent-relaxes patient for rest

  • Hypnotic agent- produces sleep

  • Age considerations

  • Benzodiazepines : diazepam (Valium), flurazepam (Dalmane), lorazepam (Ativan)

  • Barbituates: secobarbital (Seconal) short acting, amobarbital (Amytal) intermediate phenobarbital (Luminal) long acting.


Misc sedative hypnotic
MISC. SEDATIVE-HYPNOTIC sleep. What should the nurse do first?

  • Chloral derivatives- choral hydrate (Noctec)

  • Zaleplon ( Sonata)

  • Zolpidem (Ambien)

  • Trozodone (Desyrel)

  • Non prescription sleep aids

  • Case Study


Comfort and pain
COMFORT AND PAIN sleep. What should the nurse do first?

AN INTRODUCTION


What is pain
WHAT IS PAIN??? sleep. What should the nurse do first?

  • Definition

  • Pain Myths

  • Acute vs Chronic

  • Neuropathic Pain

  • Factors affecting pain experience

    age

    previous experience

    cultural and attitudes


Pain assessment
PAIN ASSESSMENT sleep. What should the nurse do first?

  • Location

  • Intensity

  • Quality

  • Associated factors

  • Alleviating factors

  • Physiological responses

  • Pain Intensity scales

  • Pain Assessment tool


Pain management
PAIN MANAGEMENT sleep. What should the nurse do first?

  • Alleviation of Pain or reduction to acceptable level of comfort

  • Views on Mgmt: HPNA and NIC

  • Client education is Crucial

  • Nurse-Client Relationship

  • Pharmacologic vs Nonpharmacologic


Pharmacologic opioids
PHARMACOLOGIC/OPIOIDS sleep. What should the nurse do first?

  • Pure Opioid Agonists: produce maximal response from cells when they bind to the cells’ opioid receptor sites. Morphine, fentanyl, methadone, hydromorphine (Dilaudid), codeine, meperidine (Demerol), oxycodone

  • Mixed Agonists-antagonists: ceiling effect for pain relief. Activate one opioid receptor while blocking another.


Pharmocologic nsaids
PHARMOCOLOGIC/NSAIDS sleep. What should the nurse do first?

  • Prevents production of Prostaglandin

  • COX-1 normally present in GI tract

  • Classified by chemical structure

    propionic: Ibuprofen (Advil), naproxen (Aleve)

    acetic: indomethacin (Indocin)

    salicylate: aspirin, sodium salicylate

    cox-2 inhibitors: celecoxib (Celebrex), rofecoxib


Pharmacologic adjuvants
PHARMACOLOGIC/ADJUVANTS sleep. What should the nurse do first?

  • Tricyclic Antidepressants

  • Anticonvulsants

  • Corticosteroids


Complementary alternative therapy
COMPLEMENTARY/ALTERNATIVE THERAPY sleep. What should the nurse do first?

  • Heat/cold application

  • Acupuncture and therapeutic touch

  • Relaxation, massage, imagery

  • Herbal remedies

  • Biofeedback

  • TENS

  • Psychotherapy and hypnosis


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