Sleep and Rest

Prepare: Sleep and Rest

• The Importance of Sleep
• Sleep is important for the restoration of biological processes including tissue renewal.

Parasomnias

• Which of the following is true of the group of sleep disorders known as parasomnias? Select all that apply.

Normal Sleep Pattern

• Select the correct characteristics associated with a normal sleep pattern.

Self-Check: Understanding Normal Sleep

• Why is it important for the nurse to understand the stages and characteristics of normal sleep? Select all that apply.

Self-Check: Sleep Characteristics of Adults

• The sleep characteristics of adults include which of the following? Select all that apply.

Self-Check: Sleep Characteristics of Adolescents

• The sleep characteristics of adolescents include which of the following?

Self-Check: Insomnia

• Which of the following statement(s) is true regarding insomnia? Select all that apply.

Self-Check: Sleep Deprivation

• Which of the following is true about sleep deprivation?

Reflect: Sleep and Rest

Factors Affecting Sleep

• There are many factors that affect sleep. Which of these factors can the nurse impact to decrease the likelihood of sleep disturbances for the hospitalized client? Select all that apply.

Sleep Characteristics

• Match the client’s age to the correct sleep characteristic.

Proper Rest and Sleep

• What impact can the nurse expect sleep disturbances to have on clients with the following issues? Match the sleep disturbance issues to the client scenario. Issues may be pertinent to multiple scenarios.

Sleep Disorders

• Which of the following sleep disorders often requires a machine providing positive pressure at night?

Narcolepsy

• Based on the nurse's knowledge of narcolepsy, which of the following is the priority concern for the nurse caring for a client diagnosed with narcolepsy?

Parasomnias

• Based on the nurse's knowledge about sleep disorders, which of the following situations presents a client safety concern for the nurse? Select all that apply.

Normal Sleep Patterns

• Based on the knowledge of normal sleep patterns, the nurse caring for a client who is in the deepest stage of sleep would expect to observe which of the following clinical signs during hourly rounds? Select all that apply.

The Stages of Sleep

• Match the stages of sleep.

Pain Management

Prepare: Pain Management

Managing Pain

• Which of the following must the nurse understand about pain?

Physiological Cues of Pain

• Which physiological pain cue can be observed in a client with neurological deficit which is preventing the client from verbalizing pain?

Psychological Pain Factors

• There are various psychological factors which influence a client's pain and impact how the nurse may help a client in pain during care. Select the statement(s) which most accurately explains how attention paid to pain influences a client's perception of pain. Select all that apply.

Self-Check: Cancer Pain

• The nurse caring for a client diagnosed with cancer knows which of the following are true about cancer pain? Select all that apply.

Self-Check: Physiological Pain Cues

• The nurse knows that there are physiological cues that indicate pain. Which of the following symptoms demonstrates a client is experiencing low to moderate or superficial pain?

Self-Check: Bias and Pain

• Which of the following statements by the nurse are free from bias or generalizations about pain? Select all that apply.

Self-Check: Pain and Age

• Which of the following statements is accurate about pain related to age and developmental stage?

Self-Check: Quality of Life: Chronic Pain

• Which of the following statements indicates an appropriate response to chronic pain management?

Reflect: Pain Management

Lower Back Pain

• A client is experiencing chronic pain after a motor vehicle accident six months ago. The nurse knows which symptoms are associated with chronic pain? Select all that apply.

Cause or Effect

• The nurse understands that pain can cause a physiological response even when a client is unable to verbally express pain. Match a symptom the nurse would see in someone with severe pain, and the reason for the physiologic change.

Assessing Pain

• Which of the following should the nurse ask from a client when assessing pain?

Physiological Cues

• The nurse knows that the prolonged stress of severe or deep pain on the body can lead to a failure in the body’s defenses, in contrast to the stress response associated with low to moderate or superficial pain. Drag the symptoms to indicate if they are physiological cues related to severe or deep pain versus low to moderate or superficial pain.

Personal Bias

• Which statements, by the nurse, indicate that their personal beliefs may negatively impact the care of a client in pain? Select all that apply.

Type of Pain

• Which of the following is an accurate statement about the goal of nursing care in managing clients’ pain? Select all that apply.

Pain Medication

• Which actions should the nurse take to promote the effectiveness of pain medication administered to a client experiencing low back pain of 8 on a 0 -10 numeric pain scale? Select all that apply.

Patient-Controlled Analgesia Pump

• The nurse enters the room of a sleeping client who is recovering from surgery and is receiving pain medication via a patient-controlled analgesia PCA pump. Which nursing actions are indicated? Select all that apply.

Nursing Application for Sleep, Rest, and Pain

Prepare: Nursing Application: Sleep, Rest, and Pain

Pain Assessment

• The nurse knows which statement is true about pain?

Chronic Pain Symptoms

• Which physiological symptom can be found with a client experiencing chronic pain?

Relationship of Sleep and Rest to Pain

• A nurse is planning care for a client who is experiencing pain and is unable to sleep. The nurse understands which statements are true regarding the relationship between sleep, rest, and pain? Select all that apply.

Managing Pain

• In order to manage the client's pain, the nurse must use critical thinking to synthesize the information gathered from the client with the appropriate knowledge, skills, and attitudes toward pain. The type of pain the client is experiencing will impact the nursing care provided. Which statements are accurate about managing client’s pain? Select all that apply.

Self-Check: Recognizing Cues

• The nurse is caring for Susan, a 75-year-old female, who was diagnosed with ovarian cancer 7 months ago following the discovery of a large inoperable tumor. After receiving a hand-off report from the previous shift RN, the nurse reads through Susan’s electronic medical record and enters Susan’s room for shift assessment. The following data was collected. Select the information that requires further follow-up by the nurse.

Self-Check: Forming Hypotheses

• You have determined Susan’s priority needs based on the data collected. Potential nursing diagnoses are listed. Choose the nursing diagnoses that match the etiology (cause). Select all that apply.

Self-Check: Generating Solutions

• The nurse addresses Susan's current pain first. Susan states that she would like her pain to be managed so she can sleep at least four hours at a time within the next 2 days and at a level of no higher than 4. Her pain level is currently at 6 or 7 on a 0-10 pain scale. Which of the following care options are most appropriate in assisting Susan to meet her goals?

Self Check: Implementation - Take Action

• Susan reports pain level increasing in intensity at 7 out of 10 on the pain scale. The nurse will take action to implement the following nursing interventions to help manage the client's pain. Rank the interventions based upon priority.

Self-Check: Evaluate Outcomes

• Susan’s vital signs are: T 98.2F, HR 115, BP 110/62, RR 16. When asked to describe her pain, she reports it as “7” on a 0-10 pain scale. She reports still having difficulty sleeping, only 3 hours per night. For each assessment finding, specify if the client’s conditions have improved, not improved, or are unrelated.

Reflect: Nursing Application of Sleep, Rest, and Pain

Recognize Cues

• Which of the following assessment findings requires immediate follow-up?

Analyze Cues

• Judy, 55-years-old, was admitted for a colon resection for a cancerous tumor. The surgeon ordered a morphine sulfate patient-controlled analgesia (PCA) pump to help control the pain. The client has not had surgery before, so is unsure what to expect. She has a history of cancer and diabetes mellitus type 1.

Vital signs HR 48, BP 90/50, RR 10, and spO2 89% on room air. The client is nauseated and reported dizziness and a headache. She rates her pain 8 out of 10 on a pain scale and is uncomfortable to move and unable to rest.

The overall goals for postoperative care are to manage pain, prevent infection, and immobility complications. Rank the nursing diagnosis based upon the overall goals. 1 is highest priority and 5 lowest priority.

Generate Solutions

• Judy, 55-years-old, was admitted for a colon resection for a cancerous tumor. The surgeon ordered a morphine sulfate patient-controlled analgesia (PCA) pump to help control the pain. The client has not had surgery before, so is unsure what to expect. She has a history of cancer and diabetes mellitus type 1. Vital signs HR 48, BP 90/50, RR 10, and spO2 89% on room air.

The client is nauseated and reported dizziness and a headache. She rates her pain 8 out of 10 on a pain scale and is uncomfortable to move and unable to rest.

Prior to discharge, the nurse establishes nursing actions in the plan of care to help meet client goals. Match the nursing diagnosis with the appropriate nursing action.

Take Action

• Judy, 55-years-old, was admitted for a colon resection for a cancerous tumor. The surgeon ordered a morphine sulfate patient-controlled analgesia (PCA) pump to help control the pain. The client has not had surgery before, so is unsure what to expect. She has a history of cancer and diabetes mellitus type 1. Vital signs HR 48, BP 90/50, RR 10, and spO2 89% on room air.

The client is nauseated and reported dizziness and a headache. She rates her pain 8 out of 10 on a pain scale and is uncomfortable to move and unable to rest.

Which of the following nursing actions should the nurse take? Identify if they are indicated or nonindicated.

Evaluate Outcomes

• Judy, 55-years-old, was admitted for a colon resection for a cancerous tumor. The surgeon ordered a morphine sulfate patient-controlled analgesia (PCA) pump to help control the pain. The client has not had surgery before, so is unsure what to expect. She has a history of cancer and diabetes mellitus type 1.

Vital signs HR 48, BP 90/50, RR 10, and spO2 89% on room air. The client is nauseated and reported dizziness and a headache. She rates her pain 8 out of 10 on a pain scale and is uncomfortable to move and unable to rest.

What assessment finding would indicate that the client's outcomes have been met or not met.

Nursing Interventions

• Which nursing actions can decrease the likelihood of sleep disturbances in the hospital for a client experiencing pain?

Common Statements

• Which of the following client statements is the most concerning to the nurse?