Nokea
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.
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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.
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 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.
A patient experiencing menopause tells the nurse at the medical clinic that she would like to try a CAH hormonal sleep aid like her friend uses. What information can the nurse give the patient?
- A. Melatonin, an over-the-counter hormonal sleep aid, has varied effectiveness.
- B. Lavender is a hormonal scented sleep aid.
- C. Lorazepam, a naturally occurring benzodiazepine, is recommended for sleep.
- D. Valerian is a natural hormonal sleep aid.
Correct Answer: A
Rationale: Melatonin, used as a complementary or alternate to traditional pharmacologic agents, is a hormone thought to regulate the sleep-wake cycle. Valerian is an herb; lavender is a plant used for aromatherapy and relaxation. Benzodiazepines are pharmacologic medications used to decrease anxiety and promote sleep and relaxation.
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.