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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.
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A nurse is providing discharge teaching for patients regarding their medications. For which patients would the nurse recommend actions to promote sleep?
- A. Patient taking iron supplements for anemia
- B. Patient with Parkinson's disease who is taking dopamine
- C. Older adult taking diuretics for congestive heart failure
- D. Child taking antibiotics for an ear infection
- E. Patient taking antidepressants
- F. Patient taking low-dose aspirin prophylactically
Correct Answer: B,C,E
Rationale: Drugs that decrease REM sleep include barbiturates, amphetamines, and antidepressants. Diuretics, antiparkinsonian drugs, some antidepressants and antihypertensives, steroids, decongestants, caffeine, and asthma medications are seen as additional common causes of sleep problems.
A nurse observes involuntary muscle jerking in a sleeping patient. What action will the nurse take next?
- A. No action is necessary; this is normal in stage 1 sleep.
- B. Report the neurologic deficit to the health care provider.
- C. Lower the temperature in the patient's room.
- D. Awaken the patient, as this is an indication of night terrors.
Correct Answer: A
Rationale: Involuntary muscle jerking occurs in stage I NREM sleep and is a normal finding. No further actions are needed for this patient.
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 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.
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.