Exam (elaborations)
221_ Sleep. Questions & answers
221_ Sleep. Questions & answers
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221: SleepHow is the concept of sleep defined and described? - ANS-• sleep is natural, necessary,
involves a shift in physiological and neurologic activity, and is intended to be restorative
The heart beats 10 to 20 fewer times per minute when sleeping, and respirations, blood
pressure, and muscle tone all ___________ during sleep - ANS-decrease
Rapid eye movement (REM) sleep - ANS-Occurs during deep sleep and is manifested
by quick scanning movements of the eyes that are associated with dreaming.
REM sleep is associated with memory storage, learning, increased cerebral blood flow,
and epinephrine release
non-rapid eye movement (NREM) sleep - ANS-REM does not occur, growth hormone is
released to repair epithelial and brain cells, cell division for skin and bone marrow
renewal occurs, and energy is conserved
melatonin - ANS-A hormone manufactured by the pineal gland that produces
sleepiness.
Polysomnography - ANS-test to monitor brain waves, muscle tension, eye movement,
and oxygen levels in the blood as the patient sleeps
What does a normal polysomnography show? - ANS-a sleep sequence of four NREM
stages and one REM stage
NREM 1 - ANS-• Lightest level of sleep, between sleep and wakefulness
• Vital signs and metabolism begin to decrease/slow down
• Easy arousal by external stimuli, such as noise
• Feeling of drowsiness
• Lasts a few minutes
• May occur during the day as "resting my eyes"
,NREM 2 - ANS-• Relaxation increases
• Sleep becomes deeper
• Snoring may occur
• Relatively easy arousal
• Physiologic functions continue to slow
• Accompanied by occasional small muscle jerks
• Lasts 10-20 min
NREM 3 - ANS-• Initial stage of deep sleep
• More difficult arousal and rare movement
• Muscles relaxed
• Vital signs decrease, but regular rhythms/patterns maintained
• Restorative processes such as the release of growth hormone occur ***
• Lasts 15-30 min
NREM 4 - ANS-• Deepest stage of sleep
• Strong stimuli needed for arousal
• Vital signs decreased much more than during wake time
• Restorative processes continue
• Somnambulism and nocturnal enuresis (bed wetting) may occur
• May be lengthy period of sleep if sleep deprivation has occurred
• Lasts 15-30 min
, REM - ANS-• Occurrence of vivid, colorful dreaming (less vivid dreaming may occur in
other stages)
• Starts approximately 90 min after sleep is initiated
• ** Autonomous response causes rapid eye movements, fluctuating heart rate and
respirations, and increased blood pressure
• Muscle tone decreased
• Gastric secretions increased
• Very difficult arousal
• Duration of REM sleep increases with each sleep cycle and averages 20 min
Newborns should sleep in ____ to ____ -hour blocks between feedings - ANS-2 to 4
What should parents be taught regarding their newborns/infants in relation to sleep? -
ANS-Position newborns and infants on the back for sleeping, to decrease the risk of
sudden infant death syndrome or (SIDS)
How often do infants normally sleep? - ANS-10 to 12 hours at night, with naps during
the day
(half of their sleep is in lighter stages)
A mother tells you her infant's aunt made the infant a baby blanket with the child's name
on it, how should you as the nurse respond to the mother? - ANS-Educate the mother
on keeping the baby blanket as well as pillows, and bumpers out of the crib in order to
decrease suffocation risk
A father explains to the nurse that his infant's eyes seem to be moving while the infant is
sleeping, what will the nurse tell the father - ANS-The nurse will tell the father that eye
movements, grimacing, and body movements are normal features of sleep at this age
At what age can a toddler move out of the crib to a bed? - ANS-Approximately 2 years
old.
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