Nokea
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.
You may also like to solve these questions
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 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 caring for patients in a long-term care facility is implementing interventions to help promote sleep in older adults. Which is the best action for these patients?
- A. Increase physical activities during the day.
- B. Encourage short periods of napping during the day.
- C. Increase fluids during the evening.
- D. Dispense diuretics during the afternoon hours.
Correct Answer: A
Rationale: In order to promote sleep in the older adult, the nurse should encourage daily physical activity such as walking or water aerobics. The nurse discourages napping during the day, decreases fluids at night, and dispenses diuretics in the morning (or early evening when necessary).
A nursing student is caring for an older adult with arthritis who states she did not sleep well and was 'up all night to use the bathroom.' To help promote sleep, the student plans to discuss re-timing which medication with the primary nurse?
- A. Furosemide (diuretic) 10:00 AM, 10:00 PM
- B. Melatonin 9:00 PM
- C. Acetaminophen 10:00 AM, 10:00 PM
- D. Artificial tears every 8 hours, 8:00 AM, 2:00 PM, 8:00 PM
Correct Answer: A
Rationale: It is best to administer diuretics in the morning or early evening to prevent nocturia. Melatonin promotes sleep and rest. Acetaminophen can relieve arthritis pain and help promote rest. Artificial tears, used for dry eyes, will not affect sleep.
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.