20.12: Chapter 12 (Sleep and Rest)

Answer Key to Chapter 12 Learning Activities

Scenario A

A nurse is caring for a patient who has been hospitalized after undergoing hip-replacement surgery. The patient complains of not sleeping well and feels very drowsy during the day.

1. The patient may be experiencing pain that is disrupting the sleep pattern. Additionally, the inpatient hospital settings may present unintended interruptions such as assessment and vital sign collection. Measures should be taken to create a quiet, therapeutic environment and minimize interruptions during sleeping hours.

2. The nurse should assess the patient’s pain level, general comfort, and self-reported feeling of restfulness upon awakening. The nurse should also carefully examine the patient’s rest pattern by asking questions regarding length of rest, period of wakefulness, and intervals with which these occur throughout the day.

3. The patient will have uninterrupted rest of six hours each night during their hospitalization.

4. The nurse should consider pain medication intervention and strategies to create a therapeutic and restful environment. This includes minimizing interruption overnight, clustering care and interventions, limiting noise or distractions, etc. The nurse should also consider if sleep aids are needed while being mindful of the impact of these medication aids in relation to fall risk. The nurse should also take measures to advocate for quiet periods for the patient.

5. The nurse would determine the effectiveness of interventions by monitoring the patient’s level of alertness throughout the daytime hours, self-reported level of energy, and ability to participate in therapy and care activities.

Scenario B

A nurse is assigned to work rotating shifts and develops difficulty sleeping.

1. Rotating shifts impact an individual’s sleep pattern because of the disruption to one’s circadian rhythm.

2. Symptoms of insomnia include lying awake for a long time before falling asleep, sleeping for only short periods, waking up too early in the morning and not being able to get back to sleep, waking up feeling unrested, difficulty focusing on tasks, irritability, anxiousness, and depression.

3. Healthy sleep habits include the following:

• Sleep in a cool, quiet place. Avoid artificial light from the TV or electronic devices, as this can disrupt your sleep-wake cycle.
• Go to sleep and wake up around the same times each day, even on the weekends. If you can, avoid night shifts, irregular schedules, or other things that may disrupt your sleep schedule.
• Avoid caffeine, nicotine, and alcohol close to bedtime.
• Get regular physical activity during the daytime (at least 5 to 6 hours before going to bed).
• Avoid daytime naps, especially in the afternoon.
• Eat meals on a regular schedule and avoid late-night dinners to maintain a regular sleep-wake cycle.
• Limit how much fluid you drink close to bedtime.
• Learn new ways to manage stress.
• Avoid certain over-the-counter and prescription medicines that can disrupt sleep (for example, some cold and allergy medicines).

Answers to interactive elements are given within the interactive element.