Fundamentals of Nursing: Rest and Sleep Flashcards


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1

Rest

- A condition in which the body is in a decreased state of activity, with the consequent feeling of being refreshed.

2

Sleep

- A state of rest accompanied by altered consciousness and relative inactivity.

- A period of inactivity and restoration of mental and physical function.

3

What two systems in the brainstem are believed to work together to control the cyclic nature of sleep?

- Reticular Activating System (RAS)

- Bulbar Synchronizing Region

4

Reticular Activating System (RAS) Functions are:

- It facilitates reflex and voluntary movements as well as cortical activities related to a state of alertness.

- Comprises many nerve cells and fibers that relay impulses into the cerebral cortex and spinal cord.

5

Benefits of sleep include:

- Increases mental performance, which in turn improves learning and helps the storage of long-term memory

- Restores energy

- Improves ability to cope

- Strengthens the immune system

6

Hypothalamus is the control center for ________ and _______.

sleeping, waking

7

Biorhythms are...

- "Biological clocks" that are controlled within the body and synchronized with environmental factors

8

Circadian Rhythm is....

- The biorhythm based on day-night pattern in a 24 hour cycle.

9

When physiologic and psychological rhythms are high or most active, the person is _____.

Awake

10

When physiologic and psychological rhythms are low, the person is ________.

Asleep

11

Non-Rapid Eye Movement (NREM) Sleep

-Comprises about 75% of total sleep time

-Consists of 4 Stages

- Low wave sleep because it is characterized by the presence of delta waves

12

NREM Stage 1 and 2 sleep percentages

- 5-50% of sleep

- Light sleep state

13

NREM Stage 3 and 4 percentages

- 10% of sleep

- Deep sleep state (delta sleep)

14

During NREM sleep the parasympathetic branch of the autonomic nervous system becomes progressively __________ _____________.

- more dominant

15

NREM Sleep Stage 1 Characteristics

- Transitional stage between wakefulness and sleep

- Relaxed state but still somewhat aware of surroundings

- Involuntary muscle jerking

- Stage normally lasts only minutes

- Person can be aroused easily

- Stage constitutes only about 5% of total sleep

16

NREM Sleep Stage II Characteristics

- Falls into a stage of sleep

- Can be aroused with relative ease

- This stage constitutes 50%-55% of sleep

17

NREM Sleep Stage III Characteristics

- Depth of sleep increases

- Arousal becomes increasingly difficult

- This stage composes about 10% of sleep

18

NREM Sleep Stage IV Characteristics

- Reaches the greatest depth of sleep, which is called delta sleep

- Arousal from sleep is difficult

- This stage constitutes about 10% of sleep

19

Physiological changes in the body during NREM Sleep Stage IV include:

- Slow brain waves are recorded on an EEG

- Pulse and respiratory rates decrease

- BP decreases

- Muscles are relaxed

- Metabolism slow and body temp is low

20

Rapid Eye Movement (REM) Sleep

- This state consumes about 20%-25% of a person's nightly sleep time

21

Rapid Eye Movement (REM) Characteristics

- Occurs about 90 minutes after the onset of sleep and after the deep sleep in stage IV

- Brain becomes highly active

- Eyes dart back and forth and small muscle twitching may occur (such as on the face)

- Vivid dreams

- Pulse, respiratory rate, BP, metabolic rate, and body temp increase

- Skeletal muscle tone and deep tendon reflexes are depressed

- Arousal from sleep is difficult

- REM sleep enters from NREM Stage II and reenters NREM sleep at stage II

22

During a sleep cycle how many stages of NREM sleep does a person pass consecutively?

Four (Stages I-IV)

23

After consecutively passing the through the four stages of NREM the pattern is then _______.

Returning from Stage ___ to ___ to ____ and entering REM sleep instead of re-entering stage ___.

- Reversed

- IV, III, II, I

24

Factors affecting rest and sleep

- Developmental considerations

- Motivation

- Culture

-Lifestyle and habits

- Physical activity and exercise

- Dietary habits

- Environmental factors

- Psychological Stress

- Illness

- Medications

25

Dyssomnias

- Sleep disorders characterized by difficulty falling/staying asleep

- Early awakening or excessive sleepiness

26

Parasomnias

- Patterns of waking behavior that appears during sleeping

27

Common Sleep Disorders

- Insomnia
- Sleep related breathing disorders (apnea)
- Circadian disorders (shift work, jet lag)
- Narcolepsy (Uncontrollable desire to sleep)
- Hypersomnia (Excessive sleep during the day)
- Parasomnias
- Restless Leg Syndrome
- Sleep deprivation
- Secondary sleep disorders (depression, thyroid problems, asthma)

28

When a sleep disturbance is noted, ask about the following when obtaining the history:

- Nature of the problem

- Cause of the problem

- Related signs and symptoms

- When problem began and how often it occurs

- How the problem affects everyday living

- Severity of the problem and whether it can be treated independently by nurses or needs to be referred to another health care professional

- How the patient is coping with the problem and the success of any treatments