chapter 18 comfort, rest, and sleep

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 18

Comfort, Rest, and Sleep

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

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?

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


Answer

False.

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


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


The Client Environment (cont’d)

• Room furnishings– Bed

o Mattresso Pillowso Linen

– Privacy curtain


The Client Environment (cont’d)

• Room furnishings (cont’d)– Overbed table– Bedside stand– Chairs


Sleep and Rest

• Functions of sleep

– Promotes emotional well-being

– Enhances various physiologic processes

– Reduces fatigue


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



• Sleep phases– Nonrapid eye movement (NREM)

o Quiet sleep– Rapid eye movement (REM)

o Active or deepest stage of sleep


Characteristic Electroencephalogram Wave Form



• Sleep cycles

– Alternate through NREM and REM phases

• Sleep requirements

– Vary among different age groups



• Factors affecting sleep

– Old age

– Light

– Activity

– Environment

– Motivation


REM and NREM Sleep in Younger Adults and Older Adults



• Factors affecting sleep (cont’d)– Emotions and moods– Food and beverages– Illness– Drugs

o Sedatives and tranquilizerso Hypnotics and stimulants


Question


Alcohol is a depressive drug that promotes healthy sleep.


Answer

False.

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


Sleep Assessment

• Sleep questionnaires

• Sleep diary

• Nocturnal polysomnography

• Multiple sleep latency test


Sleep Disorders

• Insomnia• Hypersomnia

– Narcolepsyo Sleep paralysis and cataplexyo Hypnogogic hallucinations

– Sleep apnea/hypopnea syndrome


Question


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.


Answer

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.


Sleep Disorders (cont’d)

• Sleep-wake cycle disturbances

– Shift work

– Jet travel

– Seasonal affective disorder

• Parasomnias


Nursing Implications

• Identify nursing diagnoses – Develop plan of care

• Sleep-promoting nursing measures– Maintaining sleep rituals– Reducing intake of stimulating chemicals– Promoting daytime exercise


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


General 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


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


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

chapter 18 comfort, rest, and sleep

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