N105: Essentials of Nursing Care - Health Differences

Essentials of Nursing Study Guide

©2017 Achieve Test Prep Page 126 of 160 is also known as REM deprivation. This is caused by alcohol, barbiturates, shift work, jet lag, extended ICU hospitalization, morphine, and demerol. The patient will present with excitability, restlessness, increased sensitivity to pain, and confusion. Deprivation can be a combination of NREM and REM. Interventions to promote rest and sleep Patient’s should avoid the use of sleep medications and other drugs, such as stimulants or steroids taken close to bedtime. Hypnotics and sedating antidepressants can cause excessive daytime sleepiness. • Sleep environment: should be a well ventilated, dark room, cool or warm temperature • Psychological modifications : utilize distraction, guided imagery, and soft music • Ethical and legal implications: avoid use of medication for chemical restraints • Alternative and complementary treatments: therapeutic touch, massage, white noise, and music therapy; use of a warm cup of tea or milk may also be helpful • Medications: Sleep medications, sedative hypnotic or anti-anxiety, should not be used longer than 7-10 days. Using an initial low dose and a drug with a short half-life will prevent overmedication and the hangover effects that may alter a person’s functioning during the day. Examples of short acting medications are Melatonin (1 hour), Sonata (1 hour), Ambien (2.6 hours) and Halcion (1.5-5.5 hours). Examples of long half-life medications are Ativan (10-20 hours), Restoril (9-15 hours), Chloral Hydrate (7-10 hours), Placidyl (10-20 hours) and Dalmane (47-100 hours). Sleep apnea is a periodic cessation of breathing during sleep. This is seen most frequently in men over age 50 and in postmenopausal women. Apnea lasts from 10 seconds to 2 minutes and occurs during REM or NREM sleep. Prolonged sleep apnea can cause a sharp rise in blood pressure and may also lead to cardiac arrest. Obstructive sleep apnea is when the structures of the pharynx or oral cavity block the flow of air. Some causes may be enlarged tonsils, a deviated nasal septum, and nasal polyps. Central sleep apnea is a defect in the respiratory center of the brain. This can be caused by brain stem injuries and muscular dystrophy. At this time, there is no available treatment. Mixed sleep apnea is a combination of central apnea and obstructive apnea. Parasomnia is a behavior that may interfere with sleep. Somnambulism is also known as sleepwalking, and this happens in stage 3 or 4of NREM sleep. Somnambulism usually occurs within 1-2 hours of falling asleep. The biggest concern is injury to self duringsleep. Sleeptalking is talking during NREM sleep. Sleep talking rarely presents a problem to the person unless it becomes troublesome to others. Nocturnal enuresis is bed-wetting in children over 3 years old. This is more common in males than females. Nocturnal erection begins during adolescence and does not present a sleep problem. Bruxism is a clenching and grinding of the teeth. This erodes dental crowns and causes teeth to come loose. Sleep deprivation