A nurse working in a sleep lab observes the developmental fa...

A nurse working in a sleep lab observes the developmental factors that may affect sleep. Which statements accurately describe these variations?

A. REM sleep constitutes much of the sleep cycle of a preschool child.
B. By age 8 years, most children no longer take naps.
C. Sleep needs usually decrease when physical growth peaks.
D. Many adolescents do not get enough sleep.
E. Total sleep decreases in adults with a decrease in stage IV sleep.
F. Sleep is less sound in older adults, and stage IV sleep may be absent.

Correct Answer: D,E,F

Rationale: Many adolescents do not get enough sleep due to the demands of school, activities, and part-time employment. Total sleep time decreases during adult years, with a decrease in stage IV sleep. Sleep is less sound in older adults, and stage IV sleep is absent or considerably decreased. REM sleep constitutes much of the sleep cycle of a young infant, and by the age of 5 years, most children no longer nap. Sleep needs usually increase when physical growth peaks.

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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 caring for an older adult who is having trouble falling asleep at night. What nursing interventions are appropriate for this patient?

A. Assess the patient for depression.
B. Discourage napping during the day.
C. Decrease fluids during the evening.
D. Administer diuretics in the morning.
E. Encourage the patient to engage in some type of physical activity.
F. Assess medication for side effects of sleep pattern disturbances.

Correct Answer: A,B,C,D,E,F

Rationale: For patients who are having trouble initiating sleep, the nurse should arrange for assessment for depression and treatment, discourage napping, promote activity, and assess medications for sleep disturbance side effects. Limiting fluids and administering diuretics in the morning are appropriate interventions.

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.

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 in a rehabilitation facility develops a plan to help promote patients' sleep. What interventions will the nurse include in the plan?

A. Maintain a consistent bedtime and time to awaken.
B. Drink two or three glasses of water at bedtime.
C. Have a large snack at bedtime.
D. Take a sedative-hypnotic every night at bedtime.

Correct Answer: A

Rationale: Keeping a consistent bedtime and awakening schedule, even when up late, helps promote sleep. Drinking two or three glasses of water at bedtime will probably cause the patient to awaken during the night to void. A large snack may be uncomfortable right before bedtime; instead, a small protein and carbohydrate snack is recommended. Taking a sedative-hypnotic every night disturbs REM and NREM sleep, and sedatives also lose their effectiveness quickly.