Exam (elaborations)
Gerontological Nursing, 4e (Tabloski) Chapter 8 Sleep and the Older Adult
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Gerontological Nursing, 4e (Tabloski) Chapter 8 Sleep and the Older Adult
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Gerontological Nursing, 4e (Tabloski)Chapter 8 Sleep and the Older Adult
1) Thernurserisrcaringrforranrolderrclientrwhorisrexperiencingrsleeprdeprivationrduertorarprolongedrs
tayrinrintensivercare.rWhichrmanifestationrisrthernursermostrlikelyrtorobserverinrthisrclient?
1. Constantrfatigue
2. Gustatoryrhallucinations
3. Increasedractivity
4. Needrforrrepeatedrinstructionsr
Answer:r 4
Explanation:r 1.rDaytimerfatiguerisrmorerlikelyrinrtherclientrwithrsleeprdeprivation.
2. Therclientrwhorisrdeprivedrofrsleeprmayrexperiencervisualrorrauditoryrhallucinations.
3. Therclientrmayrbermorerirritable,rbutrthisrdoesn'trtranslatertorincreasedractivity.rSmell-
relatedrhallucinationsrarerlessrlikely.
4. Learningrandrmemoryrarerseverelyrimpairedrinrtherclientrwithrarlackrofrsleep,rparticularlyrinrICU
-associatedrdelirium.
PagerRef:r185
CognitiverLevel:r Analyzing
ClientrNeed:r PhysiologicalrIntegrityrClient
rNeedrSub:r BasicrCarerandrComfort
Nurs/IntegrConc.:r NursingrProcess:rAssessment
LearningrOutcome:r 1.rDiscussrtherimportancerofrobtainingradequatersleeprandrthersleeprcycle.
2) Anrolderrclientrreportsrinsomnia.rWhatrisrtherbestrsuggestionrthernursercanrofferrthisrclient?
1. "Takingrarnaprduringrtherdayrmightrhelpryourcatchrup."
2. "Duringrtherweek,rwakerupratrthersamertimereveryrday."
3. "Drinkrarlittlerliquorrorrwinerjustrpriorrtorbedtime."
4. "Stayrbusyrduringrtherdaytimerwithrsocialrandrphysicalractivities."rA
nswer:r 4
Explanation:r 1.rGenerally,rtheramountrofrsleeprneededrisraboutrthersamerforrtheryouth,rmiddle-
raged,randrolderradult.rThoughrnapsrworkrwellrforrsomerpeople,ritroftenrhasrthereffectrofrpreventingr
goodrnighttimersleep.
2. Goodrsleeprpatternsrincluderwakingrandrgoingrtorsleepratrthersamertimereveryrday,rincludingrther
weekends.
3. Alcoholrcanrhelprsomeonergetrtorsleep,rbutrusuallyrhasrthereffectrofrdisruptingrtherlengthrofrslee
p.
4. Stayingractiverhelpsrimproverpositiverenergy,rmakesrarclearrdifferencerbetweenrdaytimerandrnig
httime,rreducesrdepression,rexposesrtherpersonrtormorerdaylightrusually,randrgenerallyrhelpsrestabli
shrarbetterrdailyrrhythm.
PagerRef:r186-
187rCognitiverLevel:r Analy
zing
ClientrNeed:r PhysiologicalrIntegrityrClient
rNeedrSub:r BasicrCarerandrComfort
Nurs/IntegrConc.:r NursingrProcess:rDiagnosis
LearningrOutcome:r 2.rDescribernormalrchangesrinrsleeproccurringrwithraging.
1
Copyrightr©r2019rPearsonrEducation,rInc.
,3) Whichrfindingsrmostrconcernrthernurserthatrarclientrisrexperiencingrsleeprapnea?rSelectrallrthat
rapply.
1. Frequentrdailyrheadaches
2. Sleepingrwithrthreerpillows
3. Daytimersleepiness
4. Restlessrlegsrduringrlongrdrives
5. ReportsrofrchokingrwhenrwakingrfromrsleeprA
nswer:r 2,r3,r5
Explanation:r 1.rMorningrheadaches,rratherrthanrheadachesratranyrpointrinrtherday,rarerassociatedrwit
hrsleeprapnea.
2. Arclientrwhorsleepsrwithrmultiplerpillowsrneedsrevaluationrtorruleroutrconditionsrsuchrasrsleeprapn
ea.rProppingrtherheadrorrtorsoruprwithrpillowsrreducesrsleeprinterruptionsrfromrtherimpairedrairwayrt
hatroccursrwithrapnea.
3. Excessiverdaytimersleepinessrisrarmanifestationrofrsleeprapnea.
4. Restlessrlegsrcanrberassociatedrwithrmanyrconditions.rFallingrasleeprwhilerdrivingrisrass
ociatedrwithrsleeprapnea.
5. Complaintsrofrchokingrwhenrwakingrfromrsleeprisrarmanifestationrofrsleeprapnea.rPa
gerRef:r188
CognitiverLevel:r Analyzing
ClientrNeed:r PhysiologicalrIntegrityrClient
rNeedrSub:r BasicrCarerandrComfort
Nurs/IntegrConc.:r NursingrProcess:rAssessment
LearningrOutcome:r 3.rIdentifyrpotentialrcausesrofrsleeprdisruptionrinrolderrpeople.
4) Anrolderrclientrisrhavingrdifficultyrsleeping.rWhatrcanrthernurserinstructrtherclientrtorhelprimp
rovertherclient'srsleep?rSelectrallrthatrapply.
1. Dornotrnaprduringrtherday.
2. Takerarwalkranrhourrbeforergoingrtorsleep.
3. Haverarglassrofrwinerbeforergoingrtorsleep.
4. Avoidrreadingrorrwatchingrtelevisionrinrbed.
5. Ifrunablertorsleep,rgetruprandrgortoranotherrroom.rA
nswer:r 1,r4,r5
Explanation:r 1.rOneractionrtorimproversleeprisrtoravoidrnappingrduringrtherday.
2. Activityrshouldrberrestrictedrtor3rhoursrbeforergoingrtorsleep.
3. Alcoholrhasrbeenrfoundrtordisruptrsleeprandrshouldrberavoided.
4. Therbedrshouldrberusedrforrsexrorrsleeprandrnotrforrreadingrorrwatchingrtelevision.
5. Oneractionrtorimproversleeprisrtorgetruprandrgortoranotherrroomrifrunablertorsleep.rPag
erRef:r203
CognitiverLevel:r Applying
ClientrNeed:r PhysiologicalrIntegrityrClient
rNeedrSub:r BasicrCarerandrComfort
Nurs/IntegrConc.:r NursingrProcess:rImplementation
LearningrOutcome:r 5.rFormulaterappropriaternursingrinterventionsrtorimproverorrrestorersleep.
2
Copyrightr©r2019rPearsonrEducation,rInc.
, 5) Thernurserisrassessingranrolderrclientrwhorwakesruprduringrthernight.rWhichrfindingrdoesrthernurs
eridentifyrasrthergreatestrriskrfactorrforrdisturbedrsleep?
1. Clientrhasrosteoarthritisrofrbothrhips.
2. Clientrdrinksrtworcupsrofrcoffeerperrday.
3. Clientrtakesrantidepressantrmedicationrinrthermorning.
4. Clientrleavesrthertelevisionronrallrdayrandrnight.rA
nswer:r 1
Explanation:r 1.rArcommonrsourcerofrpainrinrolderradultsrisrtherchronicrpainrresultingrfromroste
oarthritis.rItrcanrresultrinrchronicrsleeprdisruptionrforrolderrpeople.
2. Limitingrcaffeinerintakertoronertortworcupsrofrcoffeerperrdayrshouldrnotrinterruptrsleep.rIfrtherclien
trprefersrcoffeerlaterinrtherdayrorrmorerthanrtworcupsrtotalrduringrtherday,rthernurserassessesrforrcaffei
nertolerancerandrmakesrsuggestionsraccordingly.
3. Somerantidepressantsrhaverstimulatingreffectsrandrshouldrbertakenrinrthermorning.rThernurserass
essesrtherclientrforrevidencerofrsleepinessrfromrtherantidepressantrandrmakesrsuggestionsraccordin
gly.
4. Brightrlightsrandrnoisesrcanrdisruptrsleep.rSomerclientsrfindrcomfortrinrandrarerusedrtorcon
tinualrTV,rsorthisrisrsomethingrthernurserassessesrfurther.
PagerRef:r191
CognitiverLevel:r Analyzing
ClientrNeed:r PhysiologicalrIntegrityrClient
rNeedrSub:r BasicrCarerandrComfort
Nurs/IntegrConc.:r NursingrProcess:rAssessment
LearningrOutcome:r 3.rIdentifyrpotentialrcausesrofrsleeprdisruptionrinrolderrpeople.
6) Thernurserisrconcernedrthatranrolderrclientrwithrdementiarisrreceivingrpsychotropicrmedicatio
nsrforrsleep.rWhichrassessmentrfindingsrbestrindicatertherclientrisrexperiencingrsidereffects?rSele
ctrallrthatrapply.
1. Feelingrlightheadedruponrstanding
2. Unablertorhaverbowelrmovementrforrfourrdays
3. Hearingrarconversationrthoughrnoronerisrpresent
4. Inabilityrtorstayrawakerwhilercompletingrarpuzzle
5. Attemptingrtorswallowronerbitermultiplertimesr
Answer:r 1,r2,r4,r5
Explanation:r 1.rTypicalrsidereffectsrofrhypnoticrdrugsrincluderdizziness.
2. Typicalrsidereffectsrofrhypnoticrdrugsrincluderconstipation.
3. Typicalrsidereffectsrofrhypnoticrdrugsrdornotrincluderhallucinations.
4. Therolderrpersonrwhorroutinelyrtakesrhypnoticrdrugsrforrsleeprwillrhaverarchangerinrtherarc
hitecturerofrthersleeprcyclerandrmayrexperiencerdaytimerlethargy.
5. Typicalrsidereffectsrofrhypnoticrdrugsrincluderproblemsrwithrswallowing.rPa
gerRef:r189
CognitiverLevel:r Analyzing
ClientrNeed:r PhysiologicalrIntegrityrClient
rNeedrSub:r BasicrCarerandrComfort
Nurs/IntegrConc.:r NursingrProcess:rAssessment
LearningrOutcome:r 3.rIdentifyrpotentialrcausesrofrsleeprdisruptionrinrolderrpeople.
3
Copyrightr©r2019rPearsonrEducation,rInc.
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