Chapter 18 Comfort, Rest, and Sleep

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Chapter 18 Comfort, Rest, and Sleep. Comfort, Rest, and Sleep. Comfort facilitates rest and sleep Safe, clean, and attractive environment contributes to comfort. Question. Is the following statement true or false? - PowerPoint PPT Presentation

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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 18

Comfort, Rest, and Sleep

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Comfort, Rest, and SleepComfort, Rest, and Sleep

• Comfort facilitates rest and sleep

• Safe, clean, and attractive environment contributes to comfort

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

QuestionQuestion

•Is the following statement true or false?

Client rooms resemble bedrooms that are bare, white, and have sterile environments.

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

AnswerAnswer

False.

Client rooms are now bright, colorful, and tastefully decorated.

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

The Client Environment The Client Environment

• Environment: nursing care room, furnishings• Client rooms

– Wall: relaxing color schemes, wallpapers– Floor: carpeted or linoleum surface– Lighting: adequate lighting, adjustable

intensity– Climate control: temperature, humidity,

ventilation

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

The Client Environment (cont’d)The Client Environment (cont’d)

• Room furnishings

– Bed

o Mattress

o Pillows

o Linen

– Privacy curtain

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The Client Environment (cont’d)The Client Environment (cont’d)

• Room furnishings (cont’d)

– Overbed table

– Bedside stand

– Chairs

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Sleep and RestSleep and Rest

• Functions of sleep

– Promotes emotional well-being

– Enhances various physiologic processes

– Reduces fatigue

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Sleep and Rest (cont’d)Sleep and Rest (cont’d)

• Functions of sleep (cont’d)

– Stabilizes mood

– Improves blood flow to brain

– Improves immune system

– Improves capacity for learning and memory storage

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Sleep and Rest (cont’d)Sleep and Rest (cont’d)

• Sleep phases

– Nonrapid eye movement (NREM)

o Quiet sleep

– Rapid eye movement (REM)

o Active or deepest stage of sleep

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Characteristic Electroencephalogram Wave Form

Characteristic Electroencephalogram Wave Form

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Sleep and Rest (cont’d)Sleep and Rest (cont’d)

• Sleep cycles

– Alternate through NREM and REM phases

• Sleep requirements

– Vary among different age groups

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Sleep and Rest (cont’d)Sleep and Rest (cont’d)

• Factors affecting sleep

– Old age

– Light

– Activity

– Environment

– Motivation

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REM and NREM Sleep in Younger Adults and Older Adults

REM and NREM Sleep in Younger Adults and Older Adults

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Sleep and Rest (cont’d)Sleep and Rest (cont’d)

• Factors affecting sleep (cont’d)

– Emotions and moods

– Food and beverages

– Illness

– Drugs

o Sedatives and tranquilizers

o Hypnotics and stimulants

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QuestionQuestion

•Is the following statement true or false?

Alcohol is a depressive drug that promotes healthy sleep.

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

AnswerAnswer

False.

Alcohol is a depressive drug that promotes sleep, but it tends to reduce normal REM and deep sleep stages of NREM sleep.

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Sleep AssessmentSleep Assessment

• Sleep questionnaires

• Sleep diary

• Nocturnal polysomnography

• Multiple sleep latency test

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Sleep DisordersSleep Disorders

• Insomnia

• Hypersomnia

– Narcolepsy

o Sleep paralysis and cataplexy

o Hypnogogic hallucinations

– Sleep apnea/hypopnea syndrome

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

QuestionQuestion

•Is the following statement true or false?

Apneic episodes can be reduced by sleeping in other than the supine position, losing weight, and avoiding substances that depress respirations such as alcohol or sleeping medications.

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

AnswerAnswer

True.

Apneic episodes can be reduced by sleeping in other than the supine position, losing weight, and avoiding substances that depress respirations such as alcohol or sleeping medications.

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Sleep Disorders (cont’d)Sleep Disorders (cont’d)

• Sleep-wake cycle disturbances

– Shift work

– Jet travel

– Seasonal affective disorder 

• Parasomnias

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Nursing ImplicationsNursing Implications

• Identify nursing diagnoses

– Develop plan of care

• Sleep-promoting nursing measures

– Maintaining sleep rituals

– Reducing intake of stimulating chemicals

– Promoting daytime exercise

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Nursing Implications (cont’d)Nursing Implications (cont’d)

• Sleep-promoting nursing measures (cont’d)

– Adhering to regular schedule for retiring and waking

– Progressive relaxation

– Back massage

o Various techniques and purposes

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General Gerontologic ConsiderationsGeneral Gerontologic Considerations

• More comfortable with own bed furnishings

• Prefer warmer room temperatures

• Insomnia and hypersomnia are frequent manifestations of depression

• Sundown and sunrise syndrome

• Relaxation techniques before bedtime

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General Gerontologic Considerations (cont’d)

General Gerontologic Considerations (cont’d)

• Hypnotic medications not recommended for use longer than 2 weeks

• Difficulty falling asleep

• Institutional schedules may interfere with established pattern of sleep; modifications may be necessary

• Important to identify potential sources of sleep disorders

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

General Gerontologic Considerations (cont’d)

General Gerontologic Considerations (cont’d)

• Cognitive impairments may result in sundown or sunrise syndromes

• Chronic conditions may interfere with sleep:

– Pain

– Difficulty breathing

– Frequent urination

• Short naps or rest periods can restore energy without interfering with nighttime sleep

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