Nursing- sleep
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NREM(non-rapid-eye-movement) | about 75-80# of sleep at night Four stages
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Loss of NREM sleep causes | immunosuppression, slow tissue repair, low pain tolerance,profound fatigue, and increases susceptibility to infection
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REM sleep | occurs about every 90 min last from 5- 30 min
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Arterial changes during NREM sleep | arterial BP falls, pulse decreases, peripheral blood vessels dilate, cardiac output decreases, metabolic rate decreases, growth hormone peak levels, intracranial pressure decreases
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Loss of REM sleep causes | physiological disturbances such as apathy, depression, irritability, confusion, disorientation, hallucination, impaired memory, insomnia
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amount of sleep for newborns | 16-18 hrs on irregular schedule with pds of 1-3 hrs awake. REM sleep immediately
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amount of sleep for infants | 14-15 hrs per day. 5 hours a night with two naps per day
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amount of sleep for toddlers | between 12-14 hours in ages 1-3
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amount of sleep for preschooler | (3-5 yrs old) 11-13 hrs
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amount of sleep for school age | (5-12 yrs old) 10-11 hrs a night
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Nurses should educate parents on what for infants and newborns? | self soothing techniques. Put them to bed when drowsy not asleep
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Educate parents of toddlers | If they have enough attention from them during the day maintain a good sleep schedule will be healthy for everyone.
Soothing objects
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Educate parents of preschoolers | Maintain regular sleep schedule/ routine. Limit or eliminate TV at night to reduce nightmares.
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Educate parents and school age children | Promote healthy sleep habits
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amount of sleep for adolescents | (12-18 yrs old) 9-10 hrs
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educate parents of teens | Dangers and symptoms of sleep deprivation.
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Nocturnal emissions | wet dreams in boys. educate them that this is normal
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risk if not getting enough sleep | hypertension, depression, heart attack, stroke, car crashes
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what stage does alcohol disrupt in sleep | REM
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L- tryptophan | turkey, warm milk
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Insomnia | unrefreshed, daytime sleepiness, difficulty concentrating
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risk with hypnotic sleep aids | may lead to dependency, do not address problem
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Antihistamines | dizziness, sedation, hypotension
Not to be used w/ asthma or glaucoma
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sleep apnea | more than 5 pds/hour or five pauses lasting longer than 10 sec/h
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obstructive sleep apnea | structural defect
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central sleep apnea | brain injury
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mixed sleep apnea | combination of structure and neuro
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hypersomnia | sleep all night but cant stay awake during day
CNS damage, kidney, liver, metabolic, thyroid
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narcolepsy | onset age 15-30
adorall/amphetamines
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bruxism | stage ii non rem, teeth grinding
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periodic limb movement (PLMD) | legs jerk twice or three times/min during sleep
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somnabulism | sleep walking occurs during 3 and 4 of non rem
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valerian | mild insomnia/ RLS
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chamomile | mild sedative, some herbs harmful to liver
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sedative-hypnotic med | CNS depression
Ambien- less rebound
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antianxiety meds | decrease arousal
- not in pregnant woman
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Noctec (chloral hydrate) | 7-10 hrs
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Lunesta (eszopiclone) | 6 hrs
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Dalmane (flurazopam) | 47-100 hrs
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lorazapam (Ativan) | 10-20 hrs
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melatonin | 1 hr
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temezepam (restoril) | 9-15 hrs
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triazolam (halcion) | 1.5-5.5 hrs
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zaleplon(sonata) | 1 hour
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zolpidem (ambien) | 2.6 hrs
rapid onset
tolerance, withdrawl. dependence not demonstrated
- give just prior to bed
- contraindicated with alcohol
- do not combine with other dugs that depress CNS
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mondafinil(Provigil) | narcolepsy and excessive daytime sleepiness
half life 15hrs
- does not interfere with sleep at night
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