Nokea
A nurse caring for patients on a surgical unit should implement which recommendation to promote sleep?
- A. Keep the room light dimmed during the day.
- B. Maintain a cool temperature in the room for sleep.
- C. Keep the door of the room open for fresh air.
- D. Offer a hypnotic to patients on a regular basis.
- E. Offer pain medication prior to sleep, as needed.
- F. Provide earplugs if the patient agrees.
Correct Answer: B,E,F
Rationale: The nurse should keep the room cool and provide earplugs and eye masks if desired. The nurse should maintain a bright room environment during daylight hours and dim lights in the evening, keeping the door of the room closed to keep out extraneous noise. Sleep aid medications should only be offered as prescribed with the knowledge that they can become habit forming.
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A nurse on a postpartum unit is teaching new parents about newborn safety and sleep patterns. Which comment from a parent indicates further teaching is required?
- A. I can expect my newborn to sleep an average of 16 to 24 hours a day.
- B. Eye movements or groans during my baby's sleep is an emergency.
- C. It is essential that I place my infant on their back to sleep.
- D. I will not place pillows or blankets in the crib to prevent suffocation.
Correct Answer: B
Rationale: Eye movements, groaning, grimacing, and moving are normal activities at this age; no emergency exists. Newborns sleep an average of 16 to 24 hours a day. Infants should be placed on their backs for the first year to prevent SIDS. Parents should be cautioned about placing pillows, crib bumpers, quilts, stuffed animals, and other items in the crib as they pose a suffocation risk.
As part of interprofessional rounds, a nurse in a skilled facility assesses for sleep deficits. Patients with which health problems would the team identify as higher risk for sleep disturbances?
- A. Uncontrolled hypothyroidism
- B. Anxiety
- C. GERD
- D. HIV
- E. Arthritis
- F. Urinary tract infection
Correct Answer: A,B,C
Rationale: A patient who has uncontrolled hypothyroidism tends to have a decreased amount of NREM sleep, especially stages II and IV. Worries and anxiety can interfere with sleep, as can pain. A patient who has GERD may awaken at night with heartburn pain. Being HIV positive, taking corticosteroids, and having a urinary tract infection does not usually change sleep patterns.
At an annual health and wellness visit, the parent of an adolescent reports a teacher's concerns that their child is sleepy at school during class time. Which information will the nurse share with the parent and child?
- A. Adolescents typically need 8 to 10 hours of sleep each night.
- B. Demands on the adolescent's time causes them to sleep longer hours.
- C. Insufficient sleep can lead to daytime sleepiness.
- D. Adolescents require reduced sleep in the teen years.
- E. The adolescent could benefit from a sleep study for insomnia.
Correct Answer: A,C
Rationale: Adolescents require 8 to 10 hours of sleep nightly; however, demands on their time cut into the needed sleep. Insufficient sleep can lead to daytime sleepiness.
A nurse is providing education in a senior center on sleep and sleep hygiene in older adults. What teaching point will the nurse include?
- A. Drinking a cup of regular tea at night induces sleep.
- B. Using alcohol moderately promotes a deep sleep.
- C. Eating a bedtime snack high in tryptophan and carbohydrates improves sleep.
- D. Exercising right before bedtime can hinder sleep.
Correct Answer: C
Rationale: The nurse would teach that having a small bedtime snack high in tryptophan and carbohydrates improves sleep. Regular tea contains caffeine and increases alertness. Large quantities of alcohol limit REM and delta sleep. Physical activity within a 3-hour interval before normal bedtime can hinder sleep.
After reporting an adult patient's loud snoring and changes in vital signs occurring overnight the patient's health care provider, a nocturnal polysomnography study is prescribed. What teaching will the nurse provide about this test?
- A. This is a blood test, taken in the evening to evaluate leptin and ghrelin.
- B. The patient is monitored overnight to evaluate for sleep apnea.
- C. A patient is evaluated for leg jerking and awakenings during the night.
- D. Adults, rather than children, can be diagnosed with this test.
Correct Answer: B
Rationale: Polysomnography is an overnight sleep study to determine if an individual has sleep apnea and treatment. Leptin and ghrelin are hormones that regulate nutritional intake. Leptin signals the brain to stop eating, whereas ghrelin promotes continued eating. Research suggests that sleep deprivation lowers leptin levels and elevates ghrelin levels, increasing appetite; however, this does not help diagnose sleep apnea. Jerking legs in the early stage of intravenously is expected. Both adults and children can benefit from diagnosis of sleep apnea with this test.