Communication and nurse patient relationshipEkta Patel
This document discusses communication and the nurse-patient relationship. It defines communication and discusses its elements and types, including verbal and non-verbal communication. It also outlines techniques for effective communication, such as listening, clarification, and reflection. Key aspects of the nurse-patient relationship discussed include attending skills like maintaining eye contact and body language. The document provides an overview of the communication process and methods used between nurses and patients.
This document defines comfort devices and lists various types. Comfort devices are mechanical aids that provide optimal comfort to reduce distractions. Some key comfort devices discussed include: pillows for support; back rests to maintain sitting positions; bed cradles to prevent pressure from bedding; mattresses like air or water mattresses for comfort; trapeze bars for patient mobility; and sandbags, wedges, rings and blocks to relieve pressure on body parts. The document explains the purpose of each device in maintaining patient comfort, alignment, and mobility.
Communication is the exchange of information between individuals through common symbols. It has several purposes in healthcare including collecting data, initiating interventions, and evaluating outcomes. There are different levels of communication ranging from casual acquaintances to close friends. Effective communication requires skills like active listening, empathy, and maintaining confidentiality. Barriers can occur at physiological, psychological, environmental, and cultural levels. Maintaining good nurse-patient relationships and providing effective patient teaching are important aspects of communication in healthcare.
The document discusses proper bed making techniques. It provides instructions on preparing beds for patients by selecting the appropriate linens and arranging them in a way that ensures patient comfort and safety. Infection control measures like hand hygiene and avoiding cross-contamination of linens are emphasized. The goal is to provide a clean, tidy bed that meets patients' medical needs.
This document provides information on the care of terminally ill and dying patients. It discusses concepts of loss, grief, and the grieving process. It describes the physical and psychosocial manifestations of approaching death. It outlines nursing care for dying patients, including meeting physical needs, providing spiritual support, and supporting families. Advanced care planning tools like living wills and healthcare proxies are explained. The document also covers post-mortem care including organ donation, medico-legal issues, autopsies, embalming, and physiological changes that occur after death.
This document defines 10 different patient positioning techniques and their purposes and indications. The positions discussed include supine, prone, lateral, lithotomy, dorsal recumbent, Fowler's, Sims, Trendelenburg, knee-chest, and orthopneic. Each position is defined and the therapeutic reasons for using each position, such as for examinations, procedures, or to relieve pressure, are provided.
This document discusses admission and discharge procedures in a hospital setting. It defines admission as allowing a patient to stay in the hospital for treatment purposes. The admission process involves receiving the patient, collecting their history, orienting them and the family, and coordinating care. Discharge planning is an interdisciplinary process that ensures continuity of care after discharge and involves evaluating the patient's needs and arranging any follow up care. Nurses play an important role in both admission and discharge by properly caring for patients, educating them and families, and ensuring proper documentation and coordination of care.
A nurse fulfills many roles including caregiver, clinical decision maker, advocate, case manager, rehabilitator, comforter, communicator, teacher, and leader. As a caregiver, the nurse helps clients regain their health through the healing process and preserves their dignity. As a clinical decision maker, the nurse uses critical thinking and collaborates with the healthcare team and clients. The nurse protects clients, asks about allergies, and ensures their legal and human rights are upheld.
This document discusses hospital admission and discharge procedures. It covers the admission process including preparing the unit, admission types (emergency vs routine), admission procedures, and the nurse's role. Discharge topics include types (planned, LAMA, transfers), planning, procedures, considerations, and post-discharge unit care. Admission involves allowing a patient to stay for treatment/care. The nurse's responsibilities are to receive patients courteously, assess their condition, orient them to hospital policies and equipment, and coordinate initial care orders with physicians.
This document outlines the admission procedure for patients entering a hospital or ward. It defines admission as allowing a patient to stay for observation, investigation, treatment, and care. There are two main types of admission: emergency admission for acute conditions requiring immediate treatment; and routine admission for investigation, diagnosis, and medical or surgical treatment. The document describes the steps of the admission procedure, which include meeting the patient, verifying their information, assisting them to the treatment area, performing examinations, coordinating with physicians, giving treatment/instructions, and orienting the patient. It also outlines the roles and responsibilities of nurses in the admission process.
this topic is about sleep, stages of sleep, types of sleep, factors influencing sleep, sleep disorders and their management and various interventions to promote sleep
Types of bed in Nursing- easy explanation for Student Nurses
CLOSED BED
OPEN BED
ADMISSION BED
OCCUPIED BED
OPERATION BED/POST ANESTHESIA BED/RECOVERY BED
CARDIAC BED
FRACTURE BED
AMPUTATION BED/STUMP BED
BURN BED
This document discusses various comfort devices used in healthcare. It defines comfort and comfort devices as mechanical tools that provide optimal comfort and relieve pain, discomfort, tension and anxiety. Some key comfort devices mentioned include pillows, back rests, bed cradles, cardiac tables, mattresses, trapeze bars, footboards, trochanter rolls, sandbags, and side rails. The document explains the purpose of each device and factors that promote or inhibit patient comfort. It emphasizes that comfort devices are important for supporting patients' bodies, allowing freedom of movement, and maintaining correct positioning and alignment.
Few would disagree that nursing is one of the most underrated professions in modern times. Being a nurse isn’t easy. In fact, it is a field that can be extremely demanding and even unforgiving to those who pursue it. Being around the ailing and the frazzled for long hours and dealing with them patiently day after day can be challenging, to say the least.
A health assessment is a plan of care that identifies the specific needs of a person and how those needs will be addressed by the healthcare system or skilled nursing facility. Health assessment is the evaluation of the health status by performing a physical exam after taking a health history.
This document provides information on caring for terminally ill and dying patients, including:
- Assessing patient needs, maintaining communication, and meeting physical, psychological, and spiritual needs.
- Common signs that a patient is approaching death like changes to breathing, circulation, skin, etc.
- Providing symptomatic relief and care of the body after death like cleaning and positioning the body.
- The importance of advance directives to ensure patient wishes are followed and ease the burden on families.
- Other topics covered include euthanasia, organ donation, medico-legal issues, and post-death unit care.
The document provides information about oxygenation and oxygen therapy. It begins with an introduction defining oxygenation and its importance for life. It then discusses factors that can influence oxygenation like physiological, developmental, lifestyle and environmental factors. The document also covers various methods for oxygen administration like nasal cannula, masks and tents. It concludes with discussing complications, preparation of patients and equipment, the procedure for administration and post care activities.
Bed-making is the act of arranging the bedsheets and other bedding on a bed, to prepare it for use. It is a household chore, but is also performed in establishments including hospitals, hotels, and military or educational residences. Bed-making is also a common childhood chore.
Unit 10 Promoting Safety in Health Care Enevronment (FON).pdfKULDEEP VYAS
Healthcare environments need to provide a balance between the need for practical and clinical activities or procedures to take place within them, while creating an environment that can contribute to a good experience.
This document discusses sleep and rest patterns. It defines sleep and rest, compares their characteristics, and identifies the stages of non-REM and REM sleep. The document outlines functions of sleep, factors that affect sleep, and common sleep disorders. It also discusses conditions necessary to promote sleep and the nursing process for patients.
This document discusses sleep and rest. It defines rest and sleep, describes the stages of sleep including NREM and REM sleep. It discusses factors that affect sleep like age, illness, environment. Common sleep alterations like insomnia, sleep apnea, and parasomnias are explained. Nursing responsibilities for assessing, planning, implementing and evaluating care to promote sleep and rest are outlined.
This document discusses sleep disturbances and patterns. It begins with objectives of gaining knowledge about sleep disturbances, patterns, and their application in patient care. It then covers definitions of sleep, sleep facts, sleep patterns in different age groups, sleep physiology including stages of sleep and sleep regulation. Factors affecting sleep and consequences of sleep deprivation are explained. Common sleep disorders like insomnia are described along with international classification of sleep disorders and their management.
Indian philosophy posits three states of consciousness: waking, dreaming, and deep sleep. These states correspond to the gross, subtle, and causal bodies respectively. Several ancient Upanishads discuss states of consciousness including awake, dream-filled sleep, deep sleep, and beyond deep sleep. There are four types of brain waves - beta, alpha, theta, and delta - which occur during different stages of wakefulness and sleep. Sleep stages progress from light to deep sleep, consisting of NREM stages 1-3 and REM sleep. Neurotransmitters like acetylcholine and hormones like melatonin regulate the sleep-wake cycle which is controlled by the circadian rhythm in the hypothalamus. DNA repair occurs more during sleep, reducing
Sleep is a state of sustained immobility, reduced responsiveness, and characteristic posture that allows the body to rest and repair itself. It is essential for humans and most animals. Lack of sufficient sleep can impair functions like alertness, learning, mood, energy levels, and coordination. Brain waves change during sleep cycles from beta/alpha when awake to theta/delta when asleep. Sleep consists of REM and non-REM sleep, with dreaming occurring in REM sleep. Establishing good sleep habits and avoiding stimulants before bed can help improve sleep quality and duration.
Sleep and rest, BSC NURSING FIRST YEAR NURSING FOUNDATION , UNIT X , MEETING NEEDS OF PATIENT , PHYSIOLOGY OF SLEEP, SLEEP DISORDERS, FACTORS AFFECTING SLEEP, PROMOTING SLEEP AND STAGES OF SLEEP.
This document discusses concepts related to sleep and rest. It defines sleep and rest, compares their characteristics, and describes the two types of sleep - NREM and REM sleep. The document outlines objectives, functions of sleep, factors affecting sleep, common sleep disorders like insomnia and sleep apnea, and nursing interventions to promote sleep. Nursing diagnoses and safety measures for patients with sleep issues are also mentioned.
Sleep progresses through distinct stages in a cycle. Non-REM sleep begins with light sleep in stages 1 and 2, characterized by theta waves and sleep spindles. Stages 3 and 4 involve deep sleep with synchronized brain activity appearing as delta waves. REM sleep involves dreaming and similar brain activity to wakefulness. The circadian rhythm and homeostatic processes regulate sleep cycles, with the circadian rhythm promoting wakefulness opposed by the increasing homeostatic drive for sleep with time spent awake.
The document discusses sleep needs at different ages, sleep disorders, circadian rhythms, and the stages of sleep. Infants need 12-18 hours of sleep per night, children ages 5-10 need 10-11 hours, and teens and adults need 8-9 hours and 7-9 hours respectively. Sleep disorders include insomnia, sleep apnea, REM sleep behavior disorder, restless legs syndrome, and narcolepsy. Circadian rhythms regulate the sleep-wake cycle through exposure to light and darkness. Sleep cycles through NREM and REM stages with different brain wave patterns in each stage.
This document discusses the importance of rest for the body and mind. It notes that Jesus recognized the need for his disciples to take time away from their busy schedules to rest. The document then discusses the stages of sleep and why sleep is important for physical and mental restoration. It notes that lack of sleep can impair memory, concentration, immune function and more. Finally, it provides tips on promoting good sleep habits and highlights that the Sabbath was created by God as a day of rest.
This document discusses the importance of sleep and provides information about sleep stages and cycles. It defines sleep and discusses how sleep changes throughout life. The stages of sleep include stage 1, 2, 3 and REM sleep. A normal sleep cycle takes 90-120 minutes and includes progression through the stages before REM sleep. Deep sleep occurs in stage 3. Dreams typically occur during REM sleep. The benefits of good sleep for health are also outlined, including keeping the heart healthy, reducing stress, and improving memory and weight control.
Dr. Suresh Kumar Murugesan is a professor and researcher in psychology from Madurai, India. He specializes in areas like psychotherapy, positive psychology, education psychology, and cyber psychology. The presentation discusses sleep, explaining that it is essential for survival and important for brain functions. It describes the different stages of sleep - stages 1 to 4 of non-REM sleep and REM sleep. Brain structures like the hypothalamus, brain stem, and pineal gland are involved in regulating sleep cycles. Sleep is controlled by circadian rhythms and homeostasis. Lack of quality sleep can increase health risks like high blood pressure and depression. The document also covers brain waves and the different frequency bands measured during different states of
This document defines and discusses sleep patterns, types of sleep, functions of sleep, factors affecting sleep, and common sleep disorders. It begins by defining rest and sleep and comparing their characteristics. There are two main types of sleep: non-rapid eye movement sleep (NREM) which has three stages, and rapid eye movement (REM) sleep. Key functions of sleep include energy conservation, thermoregulation, brain function, memory consolidation, and physical health benefits. Factors affecting sleep include age, illness, environment, lifestyle, emotional stress, and drugs/substances. Common sleep disorders discussed are insomnia, parasomnia, and narcolepsy. Conditions to promote healthy sleep are also outlined.
This document provides an overview of concepts related to sleep including definitions of sleep and rest, the two types of sleep (NREM and REM), sleep cycles and stages, factors that affect sleep, functions of sleep, and common sleep disorders. It also discusses nursing assessments of sleep and potential nursing diagnoses and interventions to promote healthy sleep.
This document defines sleep and rest, compares their characteristics, and discusses sleep patterns and disorders. It outlines two types of sleep - NREM and REM sleep - and explains their stages and functions. Factors affecting sleep and common sleep disorders like insomnia and sleep apnea are identified. Nursing interventions to promote sleep through environmental changes, relaxation techniques, and medication administration if needed are also discussed.
The fund aims to provide financial support to small businesses and entrepreneurs who are just starting out or expanding their operations. It will offer loans and grants of up to $50,000 to eligible applicants looking to start a new business or grow an existing one. Priority will be given to applicants operating in rural areas, women-owned businesses, and businesses promoting environmentally sustainable practices.
This document discusses the importance of sleep for health. It describes the five stages of sleep, including rapid eye movement (REM) sleep and non-REM sleep. Insufficient sleep can increase risks for various diseases like obesity, diabetes, and heart disease due to changes in hormones like ghrelin and leptin. Getting 7-9 hours of sleep per night is recommended to maintain good health and reduce risks.
The document discusses fatigue experienced by seafarers working irregular schedules. It covers three main points: 1) Causes of fatigue include irregular work schedules, environmental factors, and personal health issues which disrupt circadian rhythms and reduce sleep quality and quantity. 2) Fatigue impairs cognitive abilities and increases risk of errors and microsleep. Signs include heavy eyes and slurred speech. 3) Irregular schedules reduce total sleep time, leading to performance declines especially at night, increasing risks of accidents similar to patterns seen in road accidents. Maintaining adequate, regular sleep is important to prevent building up a sleep debt and fatigue.
Sleep is essential for normal functioning and survival. It helps the body and brain restore and repair. There are different sleep stages that provide different benefits. Most adults need 7-9 hours of sleep per night, though individual needs vary. Lack of sufficient sleep can seriously impair performance and health, increasing risks of accidents, illness, and mental health issues.
The outcome of this course is for the learner to describe the normal stages of sleep, common sleep measurement tools sleep characteristic, common sleep disorders, the changes that affect the quality and quantity of sleep as an individual ages, and methods the healthcare provider can use to assess and assist clients with sleep disorders.
Similar to Rest, Sleep and Comfort measures.pptx (20)
Community resources are defined as any assets that can be used to meet health needs and include human, financial, material, and time resources. Key human resources are health workers, volunteers, and community organizations, while financial resources include funds from governments and organizations. Material resources encompass physical infrastructure, supplies, and land donations. Proper identification, allocation, and use of available community resources are vital for effective healthcare provision.
The document outlines the key components of community diagnosis, which include demography, causes of mortality and morbidity, use of health services, nutrition, society and culture, leadership patterns, mental health, environment, and knowledge/attitudes/practices of the population regarding health. It also describes the methods and techniques used in community diagnosis, such as identifying problems/needs/resources through primary and secondary data collection, and the steps involved, including developing definitions, collecting background information, selecting communities, data collection/analysis, and prioritizing health needs and actions.
This document discusses community diagnosis and its importance. It defines community diagnosis as a comprehensive assessment of a community's health status and the social, economic, and environmental factors that influence it. The key components of community diagnosis are identifying health problems, mortality and morbidity rates, and factors that put people at risk. It differs from clinical diagnosis by examining the community as a whole rather than individuals. Community diagnosis is important as it helps identify needs, determine available resources, set priorities, and plan, implement and evaluate community health programs. It aims to understand the magnitude of health issues and how they are changing.
This document defines and classifies wounds and wound drainage. It discusses the process of wound healing, which involves inflammatory, proliferative and maturation phases. Factors that can influence wound healing include nutrition, tissue perfusion, infection and age. Wound management strategies involve moist wound healing, preventing infection, nutrition/fluids, positioning and preventing pressure ulcers. Complications of wound healing include hemorrhage, infection, dehiscence and evisceration.
This document provides information on wound dressing, irrigation, and bandaging. It defines each term and describes the purposes, principles, procedures, types of materials used, and techniques for dressing wounds, irrigating wounds, and applying bandages. Dressings are used to protect and aid in healing wounds, while irrigation helps clean wounds and bandages are used to support, immobilize, and secure dressings over wounds or injured body parts. The document outlines best practices and sterile techniques for each procedure.
Patient positioning involves properly maintaining a patient's neutral body alignment to prevent complications from immobility or injury. There are several positions used in patient care like supine, lateral, prone, and lithotomy positions. Factors like the patient's needs, abilities, disease, and hospital protocols must be considered when positioning. Positioning aims to provide comfort, relieve pressure, improve circulation, prevent deformities, and allow for interventions. Proper techniques and safety measures are followed to position patients in a systematic way.
The document discusses rehabilitation nursing. It begins by defining rehabilitation as the restoration of normal life through retraining and medical treatment after illness or impairment. Rehabilitation nursing aims to restore abilities to the highest level of function, prevent further disability, protect existing abilities, and assist present abilities.
Rehabilitation involves a team approach including nurses, physical therapists, occupational therapists, and others. It can be institution-based in hospitals or community-based using local resources. Community-based rehabilitation focuses on enhancing quality of life and involves the community, families, and disabled individuals. The role of nurses in rehabilitation includes assessment, care planning, implementation, and evaluation to improve functioning and independence.
This document provides information on lobbying, critical thinking, and decision making. It defines lobbying as attempting to influence political decisions through advocacy, and identifies three types of lobbyists. It outlines steps for effective lobbying campaigns and letter writing, including developing a plan, understanding opposing views, and following up. The document also defines critical thinking as actively conceptualizing and evaluating information to guide beliefs and actions. It describes Bloom's six levels of critical thinking and the five stages of developing critical thinking skills from unreflective to habitually high-level across domains.
More from Lumbini Medical College and Teaching Hospital, Nursing Program (9)
Chair and Presenter, Stephen V. Liu, MD, Benjamin Levy, MD, Jessica J. Lin, MD, and Prof. Solange Peters, MD, PhD, discuss NSCLC in this CME/MOC/NCPD/AAPA/IPCE activity titled “Decoding Biomarker Testing and Targeted Therapy in NSCLC: The Complete Guide for 2024.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at https://bit.ly/4bBb8fi. CME/MOC/NCPD/AAPA/IPCE credit will be available until July 1, 2025.
EXPERIMENTAL STUDY DESIGN- RANDOMIZED CONTROLLED TRIALRishank Shahi
Randomized controlled clinical trial is a prospective experimental study.
It essentially involves comparing the outcomes in two groups of patients treated with a test treatment and a control treatment, both groups are followed over the same period of time. Prepare a plan of study or protocol
a. Define clear objectives
b. State the inclusion and exclusion criteria of case
c. Determine the sample size, place and period of study
d. Design of trial (single blind, double blind and triple blind method)
2. Define study population: Most often the patients are chosen from hospital or from the community. For example, for a study for comparison of home and sanatorium treatment, open cases of tuberculosis may be chosen.
3. Selection of participants by defined criteria as per plan:
Selection of participants should be done with precision and should be precisely stated in writing so that it can be replicated by others. For example, out of open cases of tuberculosis those who fulfill criteria for inclusion may be selected (age groups, severity of disease and treatment taken or not, etc.)
Randomization ensures that participants have an equal chance to be assigned to one of two or more groups:
One group gets the most widely accepted treatment (standard treatment/ gold standard)
The other gets the new treatment being tested, which researchers hope and have reason to believe will be better than the standard treatment
Subject variation: First, there may be bias on the part of the participants, who may subjectively feel better or report improvement if they knew they were receiving a new form of treatment.
Observer bias: The investigator measuring the outcome of a therapeutic trial may be influenced if he knows beforehand the particular procedure or therapy to which the patient has been subjected.
Evaluation bias: There may be bias in evaluation - that is, the investigator(Analyzer) may subconsciously give a favorable report of the outcome of the trial.
Co-intervention:
participants use other therapy or change behavior
Study staff, medical providers, family or friends treat participants differently.
Biased outcome ascertainment:
participants may report symptoms or outcomes differently or physicians
Investigators may elicit symptoms or outcomes differently
A technique used to prevent selection bias by concealing the allocation sequence from those assigning participants to intervention groups, until the moment of assignment.
Allocation concealment prevents researchers from influencing which participants are assigned to a given intervention group.
All clinical trials must be approved by Institutional Ethics Committee before initiation
It is mandatory to register clinical trials with Clinical Trials Registry of India
Informed consent from all study participants is mandatory.
A preclinical trial is a stage of research that begins before clinical trials, and during which important feasibility and drug safety data are collected.
Following points high.
Pharmacotherapy of Asthma and Chronic Obstructive Pulmonary Disease (COPD)HRITHIK DEY
This PowerPoint presentation provides an in-depth overview of the pharmacotherapy approaches for managing asthma and Chronic Obstructive Pulmonary Disease (COPD). It covers the pathophysiology of these respiratory conditions, the various classes of medications used, their mechanisms of action, indications, side effects, and the latest treatment guidelines. Designed for students, healthcare professionals, and anyone interested in respiratory pharmacology, this presentation offers a comprehensive understanding of current therapeutic strategies and advancements in the field.
Case presentation of a 14-year-old female presenting as unilateral breast enlargement and found to have a giant breast lipoma. The tumour was successfully excised with the result that the presumed unilateral breast enlargement reverting back to normal. A review of management including a photo of the removed Giant Lipoma is presented.
Ventilation Perfusion Ratio, Physiological dead space and physiological shuntMedicoseAcademics
In this insightful lecture, Dr. Faiza, an esteemed Assistant Professor of Physiology, delves into the essential concept of the ventilation-perfusion ratio (V˙/Q˙), which is fundamental to understanding pulmonary physiology. Dr. Faiza brings a wealth of knowledge and experience to the table, with qualifications including MBBS, FCPS in Physiology, and multiple postgraduate degrees in public health and healthcare education.
The lecture begins by laying the groundwork with basic concepts, explaining the definitions of ventilation (V˙) and perfusion (Q˙), and highlighting the significance of the ventilation-perfusion ratio (V˙/Q˙). Dr. Faiza explains the normal value of this ratio and its critical role in ensuring efficient gas exchange in the lungs.
Next, the discussion moves to the impact of different V˙/Q˙ ratios on alveolar gas concentrations. Participants will learn how a normal, zero, or infinite V˙/Q˙ ratio affects the partial pressures of oxygen and carbon dioxide in the alveoli. Dr. Faiza provides a detailed comparison of alveolar gas concentrations in these varying scenarios, offering a clear understanding of the physiological changes that occur.
The lecture also covers the concepts of physiological shunt and dead space. Dr. Faiza defines physiological shunt and explains its causes and effects on gas exchange, distinguishing it from anatomical dead space. She also discusses physiological dead space in detail, including how it is calculated using the Bohr equation. The components and significance of the Bohr equation are thoroughly explained, and practical examples of its application are provided.
Further, the lecture examines the variations in V˙/Q˙ ratios in different regions of the lung and under different conditions, such as lying versus supine and resting versus exercise. Dr. Faiza analyzes how these variations affect pulmonary function and discusses the abnormal V˙/Q˙ ratios seen in chronic obstructive lung disease (COPD) and their clinical implications.
Finally, Dr. Faiza explores the clinical implications of abnormal V˙/Q˙ ratios. She identifies clinical conditions associated with these abnormalities, such as COPD and emphysema, and discusses the physiological and clinical consequences on respiratory function. The lecture emphasizes the importance of understanding these concepts for medical professionals and students, highlighting their relevance in diagnosing and managing respiratory conditions.
This comprehensive lecture provides valuable insights for medical students, healthcare professionals, and anyone interested in respiratory physiology. Participants will gain a deep understanding of how ventilation and perfusion work together to optimize gas exchange in the lungs and how deviations from the norm can lead to significant clinical issues.
Coronary Circulation and Ischemic Heart Disease_AntiCopy.pdfMedicoseAcademics
In this lecture, we delve into the intricate anatomy and physiology of the coronary blood supply, a crucial aspect of cardiac function. We begin by examining the physiological anatomy of the coronary arteries, which lie on the heart's surface and penetrate the cardiac muscle mass to supply essential nutrients. Notably, only the innermost layer of the endocardial surface receives direct nourishment from the blood within the cardiac chambers.
We then explore the specifics of coronary circulation, including the dynamics of blood flow at rest and during strenuous activity. The impact of cardiac muscle compression on coronary blood flow, particularly during systole and diastole, is discussed, highlighting why this phenomenon is more pronounced in the left ventricle than the right.
Regulation of coronary circulation is a complex process influenced by autonomic and local metabolic factors. We discuss the roles of sympathetic and parasympathetic nerves, emphasizing the dominance of local metabolic factors such as hypoxia and adenosine in coronary vasodilation. Concepts like autoregulation, active hyperemia, and reactive hyperemia are explained to illustrate how the heart adjusts blood flow to meet varying oxygen demands.
Ischemic heart disease is a major focus, with an exploration of acute coronary artery occlusion, myocardial infarction, and subsequent physiological changes. The lecture covers the progression from acute occlusion to infarction, the body's compensatory mechanisms, and the potential complications leading to death, such as cardiac failure, pulmonary edema, fibrillation, and cardiac rupture.
We also examine coronary steal syndrome, a condition where increased cardiac activity diverts blood flow away from ischemic areas, exacerbating the condition. The long-term impact of myocardial infarction on cardiac reserve is discussed, showing how the heart's capacity to handle increased workloads is significantly reduced.
Angina pectoris, a common manifestation of ischemic heart disease, is analyzed in terms of its causes, presentation, and referred pain patterns. We identify factors that exacerbate anginal pain and discuss both medical and surgical treatment options.
Finally, the lecture includes a case study to apply theoretical knowledge to a practical scenario, helping students understand the real-world implications of coronary circulation and ischemic heart disease. The role of biochemical factors in cardiac pain and the interpretation of ECG changes in myocardial infarction are also covered.
Chemical kinetics is the study of the rates at which chemical reactions occur and the factors that influence these rates.
Importance in Pharmaceuticals: Understanding chemical kinetics is essential for predicting the shelf life of drugs, optimizing storage conditions, and ensuring consistent drug performance.
Rate of Reaction: The speed at which reactants are converted to products.
Factors Influencing Reaction Rates:
Concentration of Reactants: Higher concentrations generally increase the rate of reaction.
Temperature: Increasing temperature typically increases reaction rates.
Catalysts: Substances that increase the reaction rate without being consumed in the process.
Physical State of Reactants: The surface area and physical state (solid, liquid, gas) of reactants can affect the reaction rate.
Descoperă Bucuria Vieții Sănătoase cu Jurnalul Fericirii Life Care - Iulie 2024!
Gata să te bucuri de o vară vibrantă și plină de energie? Life Care îți vine în ajutor cu Jurnalul Fericirii din Iulie 2024, un ghid complet pentru o viață armonioasă și echilibrată.
Pe parcursul a cateva de pagini pline de informații utile și inspirație, vei descoperi:
Sfaturi practice pentru o alimentație sănătoasă:
Rețete delicioase și ușor de preparat: Bucură-te de preparate gustoase și nutritive, perfecte pentru zilele călduroase de vară.
Recomandări pentru o alimentație echilibrată: Asigură-ți aportul necesar de nutrienți esențiali pentru un organism sănătos și plin de vitalitate.
Sfaturi pentru alegeri alimentare inteligente: Învață cum să faci cumpărături sănătoase și să eviți tentațiile nesănătoase.
Trucuri pentru un stil de viață activ:
Rutine de exerciții fizice adaptate nevoilor tale: Găsește antrenamente potrivite pentru a te menține în formă și energic pe tot parcursul verii.
Idei de activități în aer liber: Descoperă modalități distractive de a te bucura de vremea frumoasă și de a petrece timp de calitate cu cei dragi.
Sfaturi pentru un somn odihnitor: Asigură-ți un somn profund și reparator pentru a te trezi revigorat și pregătit pentru o nouă zi.
Sfaturi pentru o stare de bine mentală:
Tehnici de relaxare și gestionare a stresului: Învață cum să te relaxezi și să faci față provocărilor zilnice cu mai multă ușurință.
Sfaturi pentru cultivarea optimismului și a gândirii pozitive: Descoperă cum să abordezi viața cu o perspectivă optimistă și să atragi mai multă bucurie în ea.
Recomandări pentru a te conecta cu natura: Bucură-te de beneficiile naturii asupra stării tale mentale și emoționale.
Bonus:
Oferte exclusive la produsele Life Care: Beneficiază de reduceri și promoții speciale la o gamă largă de produse pentru o viață sănătoasă.
Concursuri și premii: Participă la concursuri distractive și câștigă premii valoroase.
Jurnalul Fericirii Life Care - Iulie 2024 este mai mult decât o simplă revistă. Este un ghid complet și personalizat pentru a te ajuta să obții o viață mai sănătoasă, mai fericită și mai plină de satisfacții.
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Chair and Presenter, Stephen V. Liu, MD, Benjamin Levy, MD, Jessica J. Lin, MD, and Prof. Solange Peters, MD, PhD, prepared useful Practice Aids pertaining to NSCLC for this CME/MOC/NCPD/AAPA/IPCE activity titled “Decoding Biomarker Testing and Targeted Therapy in NSCLC: The Complete Guide for 2024.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at https://bit.ly/4bBb8fi. CME/MOC/NCPD/AAPA/IPCE credit will be available until July 1, 2025.
2. Course content
★ Definition of rest and sleep
★ Physiology , types, cycles and function of sleep
★ Normal patterns of sleep and requirement
★ Factors affecting sleep
★ Common sleep disorders
★ Nursing management for promotion of sleep
3. Contd…
★ Comfort measures
❖ Bed making; purposes, types and procedure of
bed making
❖ Back care and back massage
❖ Positioning of client
4. Introduction
Sleep is a basic human need; it is a universal
biologic process common to all people. Humans
spend about one third of their lives asleep.
5. Contd…
We require sleep for many reasons:
➔to cope with daily stresses,
➔to prevent fatigue, to conserve energy,
➔to restore the mind and body, and
➔to enjoy life more fully.
6. Contd…
Sleep enhances daytime functioning, and is vital
for cognitive, physiological, and psychosocial
function (Gruber, 2013).
7. Contd…
Sleep is an important factor in a person’s quality of
life, yet sleep disorders and sleep deprivation are
an unmet public health problem, as reported by the
Centers for Disease Control and Prevention (CDC)
(2014).
8. Definition of rest and sleep
Rest :cease work or movement in order to relax,
sleep, or recover strength.
Sleep is a cyclical physiological process that
alternates with longer periods of wakefulness. The
sleep-wake cycle influences and regulates
physiological function and behavioral responses.
9. Physiology of sleep
More recently, sleep has come to be considered an
altered state of consciousness in which the
individual’s perception of and reaction to the
environment are decreased.
10. Contd…
Sleep is characterized by minimal physical activity,
variable levels of consciousness, changes in the
body’s physiological processes, and decreased
responsiveness to external stimuli.
11. Contd…
Some environmental stimuli, such as a smoke
detector alarm, will usually awaken a sleeper,
whereas many other noises will not.
It appears that individuals respond to meaningful
stimuli while sleeping and selectively disregard non
meaningful stimuli. For example, a mother may
respond to her baby’s crying but not to the crying of
another baby.
12. Contd…
The upper part of the reticular formation consists of
a network of ascending nerve fibers called the
reticular activating system (RAS), which is
involved with the sleep/wake cycle.
An intact cerebral cortex and reticular formation
are necessary for the regulation of sleep and waking
states.
14. Contd…
Neurotransmitters, located within neurons in the
brain, affect the sleep/wake cycles.
For example, serotonin is thought to lessen the
response to sensory stimulation and gamma-
aminobutyric acid (GABA) to shut off the activity in
the neurons of the reticular activating system.
15. Contd…
Another key factor to sleep is exposure to
darkness.
Darkness and preparing for sleep (e.g., lying down,
decreasing noise) cause a decrease in stimulation
of the RAS.
16. Contd…
During sleep, the growth hormone is secreted and
cortisol is inhibited.
With the beginning of daylight, melatonin is at its
lowest level in the body and the stimulating
hormone, cortisol, is at its highest.
17. Contd…
During this time, the pineal gland in the brain
begins to actively secrete the natural hormone
melatonin, and the person feels less alert.
Wakefulness is also associated with high levels of
acetylcholine, dopamine, and noradrenaline.
18. Contd…
Acetylcholine is released in the reticular formation,
dopamine in the midbrain, and noradrenaline in the
pons.
These neurotransmitters are localized within the
reticular formation and influence cerebral cortical
arousal.
19. Circadian Rhythm
Biologic rhythms exist in plants, animals, and
humans. In humans, these are controlled from within
the body and synchronized with environmental
factors, such as light and darkness.
20. Contd…
The most familiar biologic rhythm is the circadian
rhythm. It is a sort of 24-hour internal biological
clock.
The term circadian is from the Latin “circa dies”,
meaning “about a day.”
21. Contd…
Although sleep and waking cycles are the best
known of the circadian rhythms, body temperature,
blood pressure, and many other physiological
functions also follow a circadian pattern.
22. Contd…
Sleep is a complex biologic rhythm. When a
person’s biologic clock coincides with the
sleep/wake cycles, the person is said to be in
circadian synchronization; that is, the person is
awake when the body temperature is highest, and
asleep when the body temperature is lowest.
23. Contd…
Circadian regularity begins to develop by the sixth
week of life, and by 3 to 6 months most infants have
a regular sleep/wake cycle.
26. Types of Sleep
The two types of sleep are
1. NREM (non–rapid-eye-movement) sleep and
2. REM (rapid-eye-movement) sleep
During sleep, NREM and REM sleep alternate in
cycles.
27. NREM sleep
In the classical definition of NREM sleep, people
progress through four stages during a typical 90-
minute sleep cycle.
The American Academy of Sleep Medicine defines
three stages in NREM sleep, combining stages 3
and 4.
28. REM sleep
REM sleep is the phase at the end of each 90-
minute sleep cycle.
During REM sleep there is increased brain activity
associated with rapid eye movements and muscle
atonia.
29. Stages of the Sleep Cycle
1. NREM, Non rapid eye movement;
2. REM, rapid eye movement.
30. NREM (75% of Night)
N1 (Formerly Stage 1)
• Stage of lightest level of sleep, lasting a few
minutes.
• Decreased physiological activity begins with
gradual fall in vital signs and metabolism.
• Sensory stimuli such as noise easily arouse
sleeper.
• If awakened, person feels as though daydreaming
has occurred.
31. Contd…
N2 (Formerly Stage 2)
• Stage of sound sleep during which relaxation
progresses.
• Arousal is still relatively easy.
• Brain and muscle activity continue to slow.
32. Contd…
N3 (Formerly Stages 3 and 4)
• Called slow-wave sleep.
• Deepest stage of sleep.
• Sleeper is difficult to arouse and rarely moves.
• Brain and muscle activity are significantly
decreased.
• Vital signs are lower than during waking hours.
33. REM Sleep (25% of Night)
• Vivid, full-color dreaming occurs.
• Stage usually begins about 90 minutes after sleep
has begun.
• Stage is typified by autonomic response of rapidly
moving eyes, fluctuating heart and respiratory rates,
and increased or fluctuating blood pressure.
34. Contd…
• Loss of skeletal muscle tone occurs.
• Gastric secretions increase.
• It is very difficult to arouse sleeper.
• Duration of REM sleep increases with each cycle
and averages 20 minutes
35. Sleep Cycle
Normally an adult’s routine sleep pattern begins with
a pre sleep period during which the person is
aware only of a gradually developing sleepiness.
This period normally lasts 10 to 30 minutes.
36. Contd…
Individuals who have trouble falling asleep often
remain in this stage for an hour or more.
Once asleep a person usually passes through four
to six complete sleep cycles, each cycle
consisting of three stages of NREM sleep and a
period of REM sleep, for a total of 90 to 110
minutes.
37. Contd…
With each successive cycle, stage 3 (combined 3
and 4) of NREM sleep shortens, and REM sleep
lengthens.
REM sleep lasts up to 60 minutes during the last
sleep cycle.
Not all people progress consistently through the
usual stages of sleep.
40. Contd…
For example, a sleeper fluctuates back and forth for
short intervals between NREM stages 2, and 3
before entering REM sleep. The amount of time
spent in each stage varies. The number of sleep
cycles depends on the total amount of time that the
person spends sleeping.
41. Function of sleep
➢ Sleep exerts physiological effects on both the
nervous system and other body structures.
➢ Sleep in some way restores normal levels of
activity and normal balance among parts of the
nervous system.
42. Contd…
➢ Sleep is also necessary for protein synthesis,
which allows repair processes to occur.
➢ The role of sleep in psychological well-being is
best noticed by the deterioration in mental
functioning related to sleep loss.
43. Contd…
➢ Individuals with inadequate amounts of sleep
tend to become emotionally irritable, have poor
concentration, and experience difficulty making
decisions.
44. Normal patterns of sleep and
requirement
Although it used to be believed that maintaining a
regular sleep/wake rhythm is more important than
the number of hours actually slept, recent research
has shown that sleep deprivation is associated with
significant cognitive and health problems.
45. Contd…
Although reestablishing the sleep/wake rhythm (e.g.,
after the disruption of surgery) is important, it is
appropriate to allow and encourage daytime napping
in hospitalized clients.
46. Contd…
❏ Newborns sleep 12 to 18 hours a day, on an
irregular schedule with periods of 1 to 3 hours
spent awake.
❏ At the end of the first year, an infant usually takes
two naps per day and should get about 9 to 12
hours of sleep in 24 hours.
47. Contd…
❏ The school-age child (5 to 12 years of age) needs
10 to 11 hours of sleep per night, but most
receive less because of increasing demands
(e.g., homework, sports, social activities).
❏ Between 12 and 14 hours of sleep are
recommended for children 1 to 3 years of age.
48. Contd…
❏ The preschool-age child (3 to 5 years of age)
requires 11 to 13 hours of sleep per night,
particularly if the child is in preschool.
❏ Adolescents (12 to 18 years of age) require 9 to
10 hours of sleep each night; however, few
actually get that much sleep.
49. Contd…
❏ A hallmark change with age is a tendency toward
earlier bedtime and wake times. Older adults (65
to 75 years) usually awaken 1.3 hours earlier and
go to bed approximately 1 hour earlier than
younger adults (ages 20 to 30).
52. Illness
Illness that causes pain or physical distress (e.g.,
arthritis, back pain) can result in sleep problems.
Certain endocrine disturbances can also affect
sleep. Hyperthyroidism lengthens presleep time,
making it difficult for a client to fall asleep.
Hypothyroidism, conversely, decreases stage 3
sleep.
53. Environment
Environment can promote or hinder sleep. The
person must be able to achieve a state of relaxation
prior to entering a period of sleep.
Any change—for example, noise in the
environment—can inhibit sleep. The absence of
usual stimuli or the presence of unfamiliar stimuli
can prevent people from sleeping
54. Lifestyle
Following an irregular morning and nighttime
schedule can affect sleep. Moderate exercise in the
morning or early afternoon usually is conducive to
sleep, but exercise late in the day can delay sleep.
55. Contd…
The person’s ability to relax before retiring is an
important factor affecting the ability to fall asleep. It
is best, therefore, to avoid doing homework or office
work before or after getting into bed.
56. Emotional Stress
Stress is considered by most sleep experts to be the
one of the greatest causes of difficulties in falling
asleep or staying asleep.
Anxiety increases the norepinephrine blood levels
through stimulation of the sympathetic nervous
system. This chemical change results in less deep
and REM sleep and more stage changes and
awakenings.
57. Stimulants and Alcohol
Caffeine-containing beverages act as stimulants of
the central nervous system (CNS). Drinking
beverages containing caffeine in the afternoon or
evening may interfere with sleep.
Alcohol disrupts REM sleep, although it may hasten
the onset of sleep.
58. Diet
Dietary L-tryptophan—found, for example, in cheese
and milk—may induce sleep, a fact that might
explain why warm milk helps some people get to
sleep.
59. Smoking
Nicotine has a stimulating effect on the body, and
smokers often have more difficulty falling asleep
than nonsmokers.
60. Motivation
Motivation can increase alertness in some situations
(e.g., a tired person can probably stay alert while
attending an interesting concert or surfing the web
late at night). Motivation alone, however, is usually
not sufficient to overcome the normal circadian drive
to sleep during the night.
61. Contd…
Nor is motivation sufficient to overcome sleepiness
due to insufficient sleep. A combination of boredom
and lack of sleep can contribute to feeling tired.
62. Medications
Some medications affect the quality of sleep. Most
hypnotics can interfere with deep sleep and
suppress REM sleep.
Beta-blockers have been known to cause
insomnia and nightmares.
63. Contd…
Narcotics, such as morphine, are known to
suppress REM sleep and to cause frequent
awakenings and drowsiness.
Tranquilizers interfere with REM sleep. Although
antidepressants suppress REM sleep, this effect is
considered a therapeutic action.
64. Drugs That Disrupt Sleep
These drugs may disrupt REM sleep, delay onset of
sleep, or decrease sleep time:
• Alcohol •
Caffeine
• Amphetamines •
Decongestants
• Antidepressants • Narcotics
• Beta-blockers • Steroids
• Bronchodilators
65. Drugs That May Cause
Excessive Daytime Sleepiness
• Antidepressants
• Antihistamines
• Beta-blockers
• Narcotics
67. Insomnia
Insomnia is described as the inability to fall asleep
or remain asleep. Individuals with insomnia do not
awaken feeling rested.
Acute insomnia lasts one to several nights and is
often caused by personal stressors or worry.
If the insomnia persists for longer than a month, it
is considered chronic insomnia.
68. Excessive Daytime Sleepiness
Clients may experience excessive daytime
sleepiness as a result of hypersomnia, narcolepsy,
sleep apnea, and insufficient sleep.
69. Hypersomnia
Hypersomnia refers to conditions where the
affected individual obtains sufficient sleep at
night but still cannot stay awake during the day.
Hypersomnia can be caused by medical conditions,
for example, CNS damage and certain kidney, liver,
or metabolic disorders, such as diabetic acidosis and
hypothyroidism
70. Narcolepsy
Narcolepsy is a disorder of excessive daytime
sleepiness caused by the lack of the chemical
hypocretin in the area of the CNS that regulates
sleep.
71. Sleep apnea
Sleep apnea is characterized by frequent short
breathing pauses during sleep. Although all
individuals have occasional periods of apnea during
sleep, more than five apneic episodes or five
breathing pauses longer than 10 seconds per hour is
considered abnormal and should be evaluated by a
sleep medicine specialist.
72. Contd…
Symptoms suggestive of sleep apnea include loud
snoring, frequent nocturnal awakenings, excessive
daytime sleepiness, difficulties falling asleep at night,
morning headaches, memory and cognitive
problems, and irritability.
73. Contd…
Three common types of sleep apnea are
obstructive apnea, central apnea, and mixed
apnea.
Obstructive apnea occurs when the structures of
the pharynx or oral cavity block the flow of air. The
person continues to try to breathe; that is, the chest
and abdominal muscles move.
75. Contd…
Depending on the severity and chronicity of this
voluntary, albeit unintentional sleep deprivation,
individuals may develop attention and concentration
deficits, reduced vigilance, distractibility, reduced
motivation, fatigue, malaise, and occasionally
diplopia and dry mouth.
76. Parasomnia
A parasomnia is behavior that may interfere with
sleep and may even occur during sleep.
It is characterized by physical events such as
movements or experiences that are displayed as
emotions, perceptions, or dreams.
78. Assessing
A complete assessment of a client’s sleep difficulty
includes a sleep history, health history, physical
exam, and, if warranted, a sleep diary and
diagnostic studies.
All nurses, however, can take a brief sleep history
and educate their clients about normal sleep.
79. Contd…
Sleep History
A brief sleep history, which is usually part of the
comprehensive nursing history, should be
obtained for all clients entering a health care facility.
It should, however, be deferred or omitted if the
client is critically ill.
80. Key questions to ask include the following:
● When do you usually go to sleep?
● And when do you wake up?
● Do you nap?
● If so, when?
If the client is a child, it is also important to ask about
bedtime rituals.
81. Contd…
● Do you have any problems with your sleep?
● Has anyone ever told you that you snore loudly or
thrash around a lot at night?
● Are you able to stay awake at work, when driving,
or engaging in your usual activities?
82. Health History
A health history is obtained to rule out medical or
psychiatric causes of the client’s difficulty sleeping.
It is important to note that the presence of a
medical or psychiatric illness (e.g., depression,
Parkinson’s disease, Alzheimer’s disease, or
arthritis) does not preclude the possibility that a
second problem (e.g., obstructive sleep apnea) may
be contributing to the difficulty sleeping.
83. Contd…
Because medications can frequently cause or
exacerbate sleep disturbances, information should
be obtained about all of the prescribed and
nonprescription medications, including herbal
remedies, that a client consumes.
84. Physical Examination
Rarely are sleep abnormalities noted during the
physical examination unless the client has
obstructive sleep apnea or some other health
problem.
85. Contd…
Common findings among clients with sleep apnea
include an enlarged and reddened uvula and soft
palate, enlarged tonsils and adenoids (in
children), obesity (in adults), and in male clients a
neck size greater than 17.5 inches.
Occasionally a deviated septum may be noted, but
it is rarely the cause of obstructive sleep apnea.
87. Sleep Diary
A sleep specialist may ask clients to keep a sleep
diary or log for 1 to 2 weeks in order to get a more
complete picture of their sleep complaints.
88. Contd…
A sleep diary may include all or selected aspects of
the following information that pertain to the client’s
specific problem:
89. Contd…
• Time of
(a) going to bed,
(b) trying to fall asleep,
(c) falling asleep (approximate time),
(d) any instances of waking up and duration of these
periods,
(e) waking up in the morning, and
(f) any naps and their duration
90. Contd…
• Activities performed 2 to 3 hours before bedtime
(type, duration, and time)
• Consumption of caffeinated beverages and alcohol
and amounts of those beverages
• Any prescribed medications, OTC medications,
and herbal remedies taken during the day
91. Contd…
• Bedtime rituals before sleep
• Any difficulties remaining awake during the day
and times when difficulties occurred
• Any worries that the client believes may affect
sleep
• Factors that the client believes have a positive or
negative effect on sleep
92. Contd…
If the client is a child, the sleep diary or log may be
completed by a parent.
93. Diagnostic Studies
Diagnostic Studies Sleep is measured objectively in
a sleep disorder laboratory by polysomnography
(Sleep Study that monitors several parameters to
diagnose sleep disorders) in which an
electroencephalogram (EEG), electromyogram
(EMG), and electro-oculogram (EOG) are recorded
simultaneously.
94. Contd…
Electroenchephalogram: An electroencephalogram
(EEG) is a test that detects electrical activity in
your brain using small, metal discs (electrodes)
attached to your scalp.
Electromyography (EMG) is a diagnostic
procedure to assess the health of muscles and
the nerve cells that control them (motor neurons).
95. Contd…
Electrooculography (EOG) is a technique for
measuring the corneo-retinal standing potential
that exists between the front and the back of the
human eye. The resulting signal is called the
electrooculogram.
100. Diagnosis
Insomnia, the NANDA (The North American Nursing
Diagnosis Association) International (Herdman &
Kamitsuru, 2014) diagnosis given to clients with
sleep problems, is usually made more explicit with
descriptions such as “difficulty falling asleep” or
“difficulty staying asleep”;
for example, Insomnia (delayed onset of sleep)
related to overstimulation prior to bedtime
101. Nursing Diagnosis
★ Risk for Injury related to somnambulism
★ Ineffective Coping related to insufficient quality
and quantity of sleep
★ Fatigue related to insufficient sleep
★ Impaired Gas Exchange related to sleep apnea
102. Contd…
★ Deficient Knowledge (non prescription remedies
for sleep) related to misinformation
★ Anxiety related to sleep apnea and/or the
diagnosis of a sleep disorder
★ Activity Intolerance related to sleep deprivation or
excessive daytime sleepiness
103. Planning
The major goal for clients with sleep disturbances is
to maintain (or develop) a sleeping pattern that
provides sufficient energy for daily activities.
Other goals may relate to enhancing the client’s
feeling of well-being or improving the quality and
quantity of the client’s sleep.
104. Contd…
The nurse plans specific nursing interventions to
reach the goal based on the etiology of each nursing
diagnosis.
105. Contd…
These interventions may include
● reducing environmental distractions,
● promoting bedtime rituals,
● providing comfort measures,
● scheduling nursing care to provide for
uninterrupted sleep periods,
● and teaching stress reduction, relaxation
techniques, or good sleep hygiene.
106. Implementing
The term sleep hygiene refers to interventions used
to promote sleep.
Nursing interventions to enhance the quantity and
quality of clients’ sleep involve largely
nonpharmacologic measures.
107. Contd…
These involve health teaching about sleep habits,
support of bedtime rituals, the provision of a restful
environment, specific measures to promote comfort
and relaxation, and appropriate use of hypnotic
medications.
108. Contd…
For hospitalized clients, sleep problems are often
related to the hospital environment or their
illness.
Assisting the client to sleep in such instances can be
challenging to a nurse, often involving scheduling
activities, administering analgesics, and providing a
supportive environment. Explanations and a
supportive relationship are essential for the fearful or
anxious client.
109. Contd…
Different types of hypnotics may be prescribed
depending on the type of sleep problem (e.g.,
difficulties falling asleep or difficulties maintaining
sleep).
Drugs with longer half-lives are often prescribed for
difficulties maintaining sleep, but must be used with
caution in older adults.
111. Contd…
(a) the conditions that promote sleep and those that
interfere with sleep,
(b) safe use of sleep medications,
(c) effects of other prescribed medications on sleep,
(d) effects of their disease states on sleep, and
(e) importance of long periods of uninterrupted sleep
113. Evaluating
If the desired outcomes are not achieved, the nurse
and client should explore the reasons, which may
include answers to the following questions:
● Were etiologic factors correctly identified?
● Has the client’s physical condition or medication
therapy changed?
114. Contd…
● Did the client comply with instructions about
establishing a regular sleep/wake pattern?
● Did the client avoid ingesting caffeine?
● Did the client participate in stimulating daytime
activities to avoid excessive daytime naps?
115. Contd…
● Were all possible measures taken to provide a
restful environment for the client?
● Were the comfort and relaxation measures
effective?
116. Reference
● Berman, Audrey T., Synder, S. and
Frandsen, G. 2016. Kozier and Erb’s
Fundamentals for Nursing: concepts and
practice 10th Edition.USA: Pearson
● Potter , P., Perry, A. Stockert P. and Hall,
A. 2013. Fundamentals of Nursing . 8th
edition. Canada : Mosby Elsevier
Editor's Notes
American Sleep Association: What is sleep? 2017
Kozier and Erb’s Fundamentals for Nursing
Preclude : prevent from happening; make impossible
the NANDA (The North American Nursing Diagnosis Association)