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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.
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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.
A nurse recommends that a patient with a sleep disorder keep a sleep diary. Which data will the nurse ask the patient to document?
- A. Daily mental activities
- B. Daily physical activities
- C. Morning and evening body temperature
- D. Daily measurement of fluid intake and output
- E. Presence of anxiety or worries affecting sleep
- F. Morning and evening blood pressure readings
Correct Answer: A,B,E
Rationale: A sleep diary includes mental and physical activities performed during the day and the presence of any anxiety or worries the patient may be experiencing that affect sleep. A record of fluid intake and output, body temperature, and blood pressure is typically kept in the graphic record.
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 working the night shift is watching the monitors on a telemetry unit and observes a slight increase in a patient's vital signs during sleep. Which of these points will the nurse correlate to changes in vital signs?
- A. They are aware of his surroundings at this point.
- B. They are in delta sleep at this time.
- C. It would be most difficult to awaken them at this time.
- D. This is most likely an NREM stage.
- E. This stage constitutes around 20% to 25% of total sleep.
- F. The muscles are relaxed in this stage.
Correct Answer: C,E
Rationale: This scenario describes REM sleep. During REM sleep, it is difficult to arouse a person, and the vital signs increase. REM sleep constitutes about 20% to 25% of sleep. In stage I NREM sleep, the person is somewhat aware of surroundings. In stage IV NREM sleep (delta sleep), the muscles are relaxed, whereas small muscle twitching may occur in REM sleep.
A nurse in a pediatric unit notes a school-aged child snores and appears to have labored breathing during sleep. Which assessment question could the nurse ask the patient or parents?
- A. Do you have trouble sleeping?
- B. Have you missed a lot of school due to not feeling well?
- C. Have you been wetting the bed lately?
- D. Do you have a history of high blood pressure?
Correct Answer: C
Rationale: OSA (pediatric) is defined by the presence of snoring, labored/obstructed breathing, enuresis, or daytime consequences (hyperactivity or other neurobehavioral problems, sleepiness, fatigue). Adults, children, and adolescents with symptoms of OSA, including snoring, should have polysomnography to confirm the diagnosis. Although OSA may cause insomnia, this is not the primary diagnosis in this case. Narcolepsy is a condition characterized by excessive daytime sleepiness and frequent overwhelming urges to sleep or inadvertent daytime lapses into sleep. Hypertension is a consequence of OSA in adults.