Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
ATI Module
Comfort, Rest, and Sleep (Exam 2)
| Question | Answer |
|---|---|
| brains four major regions: | the cerebrum, cerebellum, diencephalon, and brainstem |
| Two internal biological mechanisms assist in regulating sleep–wake cycles. | the circadian rhythm and sleep–wake homeostasis |
| Circadian rhythms synchronize with | environmental cues such as light and temperature |
| the main structures in the brain that are essential to the process of sleep and sleep regulation are | the hypothalamus, suprachiasmatic nucleus (SCN), brainstem, thalamus, and pineal gland |
| The hypothalamus, commands a group of nerve cells that affect | sleep and arousal-wake and sleep |
| Located within the hypothalamus is the SCN, which controls | a client’s behavioral rhythm directly from the eyes through light exposure |
| damaged SCN can experience | an erratic sleep cycle since they are not able to regulate their circadian rhythm during light–dark cycles. |
| pons and medulla, that influence | rapid eye movement (REM) sleep |
| sleep-promoting cells produce | gamma-aminobutyric acid (GABA) within the hypothalamus and brainstem |
| gamma-aminobutyric acid (GABA) | GABA reduces the activity of the arousal centers. |
| The thalamus transfers information from the senses to the | cerebral cortex |
| cerebral cortex | which then processes the data and transfers it from short-term memory to long-term memory. |
| through most of the stages of sleep, the thalamus’s function is to | allow the individual to block out external distractions |
| during REM sleep, the thalamus transmits | images, sounds, and sensations, which influence the content of dreams. |
| The pineal glands are located in the brain’s two hemispheres. These glands manufacture | melatonin, a natural substance that helps the body prepare for sleep. |
| Sleep is necessary for | developing and maintaining new pathways for learning and memorization |
| sleep as a physiological function | sleep encompasses many different processes. The brain and cells (neurons) continue to communicate with each other while a person is sleeping to assist in removing the toxins that build up in the brain while the individual is awake. |
| While asleep, the body cycles through several stages of sleep. These stages are characterized by either | rapid eye movement (REM) or nonrapid eye movement (NREM) |
| rapid eye movement (REM) | rapid movement of the eyes accompanied by low muscle tone. It is associated with the dream stage of sleep |
| Brain wave frequencies and amplitudes can be detected using | electroencephalogram (EEG) |
| electroencephalogram (EEG) | a measurement of the brain’s electrical activity |
| Stages of sleep are defined based on | a client’s brain wave frequencies and amplitudes, together with eye and body movements and changes in vital signs |
| the first stage of sleep | The wake stage (NREM) |
| The wake stage (NREM) is the first stage of sleep. This cycle consists predominantly of | alpha and beta electrical brain waves |
| Alpha waves | which have a frequency range of 8 to 12 hertz, show that a client is awake but relaxed with closed eyes |
| Beta waves | which have a frequency range of 13 to 30 hertz, indicate alertness and engagement. |
| Stage 1 (NREM) of the sleep cycle is the | lightest stage of sleep |
| Stage 1 (NREM) of the sleep cycle lasts | from 1 to 5 minutes and accounts for approximately 5% of the total sleep cycle |
| Stage 2 (NREM) | It is characterized by sleep spindles (sluggish spindles that are different in length) or K-complex (brief delta waves) electrical waveforms that trigger the superior temporal gyri, anterior cingulate, insular cortices, and the thalamus. |
| Sleep spindles and K-complexes both assist in | consolidation of memory, and K-complexes maintain sleep |
| In stage 2 the body vitals change | Heart rate and body temperature decrease |
| the first sleep cycle of stage 2 lasts for | approximately 25 minutes but become progressively longer with each successive sleep cycle. Stage 2 consumes approximately 50% of a total sleep cycle. |
| Stage 3 (NREM) | It is characterized by delta waves, electrical brain waves that have a slow wave frequency and high-amplitude signal. |
| If a person is awoken in stage 3 | they may have mental cloudiness that persists for 30 to 60 minutes |
| Stage 3 (NREM) the body physically has | the immune system strengthens, and the muscles, tissues, and bones repair and regenerate. Pulse and respirations are at their lowest rate. |
| Stage 3 (NREM) & Aging | As clients age, they have fewer stage 3 cycles and more stage 2 cycles. Stage 3 is very deep sleep and lasts up to 40 minutes. |
| Stage 4 (REM) is the | dreaming stage |
| Stage 4 (REM) | appears like an awake cycle on an EEG, as it also consists of beta waves. However, the skeletal muscles remain atonic (loss of muscle tone) and do not move (which protects the individual from acting out their dreams). |
| Stage 4 (REM) body | Breathing is irregular and erratic, and heart rate may be elevated. |
| Stage 4 (REM) the fourth stage typically begins | begins 90 minutes after falling asleep. The initial cycle lasts 10 minutes, then becomes longer as the night progresses. This stage can last up to 1 hour. As clients age, they have fewer REM cycles. |
| Stages of Sleep: Stage 1 | Nonrapid eye movement (REM) sleep Breathing remains regular and muscle tone is present Body temperature starts to decrease 5% of a person’s total sleeping time |
| Stages of Sleep: Stage 2 | Non-REM sleep 50% of a person’s total sleeping time No eye movements detected, heart rate and breathing decreases, and muscles relax |
| Stages of Sleep: Stage 3 | Non-REM sleep The brain activity, through an EEG, shows the delta wave Body’s short-term hibernation period Immune system strengthens Muscles and tissues relax 25% of a person’s total sleeping time |
| Stages of Sleep: REM sleep | The heart rate and blood pressure increase Muscle mobility and body temperature decrease further Brain activity, as noted in an EEG, increases 20% to 25% of a person’s total sleeping time |
| benefits to quiet rest. | their muscles and organs have a chance to relax. Stress is reduced, mood improves, and mental alertness and clarity are enhanced through rest. |
| Sleep helps prevent | weight gain by decreasing production of ghrelin and leptin. Sleep also helps reduce the risk of type 2 diabetes by lessening the release of cortisol |
| ghrelin | the hunger hormone |
| leptin | the decreasing-hunger hormone |
| cortisol | the stress hormone: Increased levels of cortisol make it difficult for insulin to move sugar into cells. |
| Sleep has been connected to improved | concentration, mood, memory, and productivity. It also improves reaction time, hand-eye coordination, strength, and power |
| Total sleep deprivation is caused by | losing a night of sleep or by staying awake |
| become totally sleep deprived by | staying awake for 24 hours or just by staying awake for a lengthy period |
| Partial sleep deprivation occurs | when the client has decreased their sleep hours |
| If partial sleep deprivation continues | the client can progress into a chronic sleep deprivation state. |
| Selective sleep deprivation purposely | strips the client of a cycle of sleep. |
| The appropriate treatment regimen for sleep deprivation depends on the cause and severity | For example, eliminating caffeine, nicotine, and alcohol use, and developing a plan for exercising daily, can help promote sleep. Use of medications and/or therapy may also be necessary, as determined by a health care provider. |
| nonpharmacological interventions to improve sleep: | Avoid stimulants, 6 hours before bedtime routine Room dark, quiet, and at a cold temperature. go to bed when tired consistent sleep–wake cycle naps short. exercise routine avoid exercise a few hours of bedtime/ healthy diet. bedroom only sleep |
| client in an acute care setting. show that this population have | pain and discomfort, are disturbed frequently, are subject to increased noise levels, and are given pharmacological agents that may influence their sleep cycles. |
| nurses can decrease the risk of sensory overload by | lowering noise levels, dimming lights at night, providing clients with blindfolds and earplugs when appropriate, and coordinating and organizing care to minimize interruptions. |
| Employees who do shift work or have rotating night duties have a higher incidence of | job dissatisfaction and adverse health issues such as cardiovascular disease, obesity, and diabetes |
| Sleep disorders interfere with the quality of sleep: | Insomnia, sleep apnea, narcolepsy, restless legs syndrome, hypersomnolence, and night terrors are common sleep disorders |
| Sleep disorders affect | quality of life and raise safety concerns due to the potential for accidents attributable to lack of sleep. |
| The client with insomnia is | tired, has no energy, loses concentration and memory, has mood disturbances, and lacks motivation |
| chronic illnesses associated with insomnia | heart disease, hypertension, endocrine dysfunction, and arthritis |
| Treatment options for insomnia | include medications, sleep-promoting techniques and lifestyle changes, and cognitive-behavioral therapy. |
| Apnea is a condition in which | inspiratory airflow ceases for at least 10 seconds. |
| Hypopnea is a condition in which | inspiratory airflow ceases lasts 10 seconds or longer and is associated with a decrease in oxygen saturation |
| oxygen saturation | the amount of hemoglobin bound to oxygen in the client’s blood |
| Sleep apneas are classified as | either central or obstructive |
| central or obstructive Both types result from a reduction of | nerve conduction from the brainstem to the upper airway muscles and/or lower thoracic muscles such as the diaphragm |
| snoring is a common symptom of | Obstructive sleep apnea (OSA) |
| Obstructive sleep apnea (OSA) is diagnosed | using polysomnography, a technology most likely to be applied in a sleep lab. |
| Some common obstructions noted in these clients include an | inactive tongue, enlarged tonsils, and obesity. |
| Clients experience interrupted sleep, resulting in | excessive daytime sleepiness, low energy, and lack of motivation. They may still feel tired even if they acquire their recommended hours of sleep. |
| the most widely recommended treatment for OSA | Continuous positive air pressure (CPAP) |
| Continuous positive air pressure (CPAP) | is worn on the nose or mouth and nose while asleep, and air pressure is delivered to keep the airway open. |
| lifestyle changes are treatment options for sleep apnea | Sleeping on the back, smoking, alcohol consumption, and obesity can contribute to worsening OSA manifestations. Thus, eliminating these practices and following a healthy weight-loss program may improve OSA. |
| Two types of narcolepsies are distinguished: | narcolepsy (NT1) with cataplexy and narcolepsy without cataplexy (NT2) |
| Clients with narcolepsy | have difficulty staying awake. They may also experience nocturnal hallucinations, paralysis while asleep, and vivid dreams. |
| cataplexy | a brief loss of voluntary muscle tone triggered by an emotional stimulus such as laughter. |
| Clients diagnosed with NT1 lack | hypocretin in their central nervous system |
| Hypocretin, a | hormone responsible for maintaining alertness, is produced in the hypothalamus. |
| Treatment options for both types of narcolepsy include | medications, psychological counseling, short naps, and support groups. |
| Hypersomnia extreme fatigue is not associated with | poor nighttime sleep or a disturbed circadian rhythm |
| Clients with hypersomnia have many difficulties, such as | poor memory, depression, a short attention span, and irritability |
| Although the underlying cause of hypersomnia is often unknown, some cases result from | a dysfunctional autonomic nervous system, trauma to the central nervous system, and possibly genetic factors. |
| Restless legs syndrome (RLS), also called Willis-Ekbom disease, is an | uncontrollable urge to move the legs, which is often accompanied by an uncomfortable sensation. The manifestations of this neurologic sensorimotor disorder worsen in the evening and at bedtime |
| RLS can develop | at any age but more frequently in older adults. RLS’s actual cause is unknown, but it can occur with iron or vitamin deficiencies and other medical conditions such as multiple sclerosis. RLS tends to run in families, could be an inherited syndrome. |
| Restless legs syndrome (RLS) | Avoiding caffeine, nicotine, and alcohol may help control RLS symptoms. |
| Night terrors, also called sleep terrors, are a | type of parasomnia, a category of sleep disorder that involves unusual behaviors during sleep. |
| Night terrors occur during | non-REM sleep, happening most commonly in the first third of a night’s sleep, particularly for children, and usually lasting 10 to 40 minutes. |
| Night terrors, also called sleep terrors, are caused by | include age, with young children most commonly, often ending by adolescence; genetics; presence of other sleep disorders, particularly obstructive sleep apnea; anxiety, linked to posttraumatic stress disorder in adults; sleep deprivation; and fever. |
| Night terrors differ from nightmares in that | a person awakes from a nightmare recalling scary dreams, usually happen during REM sleep, most commonly in the second half of the night when REM periods are longer. With night terrors, the person does not remember the dream and may not recall wakening. |
| Classes of pharmacological medications used for sleep therapy include | GABA agonists, nonbenzodiazepine hypnotics, melatonin, antidepressants, and antihistamines |
| GABA agonists or benzodiazepines, such as alprazolam, clonazepam, and lorazepam | can cause drowsiness, relax muscles, lessen anxiety, and cause retrograde amnesia. Clients can develop physical dependence on benzodiazepines, so these agents are not recommended for long-term use. |
| the most commonly prescribed sleep medications | Nonbenzodiazepine hypnotics, such as zolpidem, zaleplon, and eszopiclone (also known as the z-drugs) |
| prescribed sleep medications. These medications can cause adverse effects | gastric discomfort, hallucinations, and memory loss. Nonbenzodiazepine hypnotics have the potential to be abused since higher doses can induce stimulation and euphoria. |
| first-line medication recommended for those of all ages | Melatonin. It is cost-effective, non-habit forming, and has few adverse effects. However, its effectiveness may be limited. |
| over-the-counter (OTC) medications such as | doxylamine succinate and diphenhydramine |
| OTC sleep aids can cause | daytime drowsiness, dry mouth, visual disturbance, difficulty urinating, and constipation. |
| When pharmacological therapy is necessary, other assessments are needed, such as | a sleep study, to evaluate clients in order to rule out other disorders |
| Which class of sleep medications is the most commonly prescribed? | Nonbenzodiazepine hypnotics |
| nonpharmacological interventions to improve sleep, including | acupuncture, mindfulness, and massage. Massage also assists in the relaxation of muscles, improvement of circulation, and fatigue |
| Nurses can help clients with complementary alternative therapies (CAT) by teaching | silently repeat mantras, practice restful breathing, and visualize restful images. |
| Yoga has also been shown | to reduce stress, decrease pain, and improve overall health. Educating clients about the benefits of yoga and assisting them with planning to attend |
| Implementing good sleep habits may involve lifestyle changes such as | following a healthier diet, exercising at a different time, going to sleep earlier, and eliminating caffeine and use of electronic devices before going to bed. |
| Nurses can assist their clients in selecting the most appropriate sleep-promoting interventions by having clients keep a | diary of their sleep habits |
| alpha waves | Electrical brain waves in the frequency range of 8 to 12 hertz. |
| beta waves | Electrical brain waves in the frequency range of 12 to 30 hertz. |
| central sleep apnea (CSA) | The reduction of the brain's transmission to the respiratory muscles resulting in the cessation of breathing. |
| circadian rhythm | Natural internal process that regulates the sleep–wake cycle within a 24-hour period. |
| comfort | Easement from the pain of suffering from negativity, emotional, and physical distress. Being comforted has one feel accepted, safe, stronger, and valued. |
| delta waves | High amplitude electrical brainwaves in the frequency range of 1.0 to 4 hertz. |
| electroencephalogram (EEG) | Measurement of the brain's electrical activity. |
| hypersomnia | A disorder of excessive daytime fatigue without improvement after more sleep. |
| insomnia | Ongoing inability to sleep despite having the opportunity to sleep. |
| K-complex | Electrical waveform on an electroencephalogram seen mainly during stage 2 sleep cycle. |
| long-term memory | Ability to recall information for an indefinite time. |
| melatonin | Hormone that regulates the sleep–wake cycle. |
| narcolepsy | Chronic sleep condition characterized by sudden sleepiness and sudden periods of sleep. |
| obstructive sleep apnea (OSA) | Recurrent episodes of upper airway collapse and obstruction while sleeping combined with waking from sleep. |
| polysomnography | A test that documents heart rate, blood pressure, breathing, oxyhemoglobin saturation, brain wave patterns, body movements, and snoring patterns. |
| rapid eye movement (REM) | Rapid movement of the eyes accompanied by low muscle tone associated with the dream stage of sleep. |
| sensory overload | Receiving stimuli at a rate and intensity beyond the brain's ability to process the stimuli in a meaningful way. |
| short-term memory | Ability to recall information for a short time. |
| sleep deprivation | When the body does not meet its biological sleep requirement, either chronically or acutely. |
| sleep spindles | Sudden burst of oscillatory activity in a frequency range of 11 to 15 hertz lasting approximately 0.5 to 1.5 seconds. |
| sleep–wake homeostasis | Assists the body to remember to sleep after a given time. |
Created by:
user-1977236