Devie Eve B.

Verdad

BSN-III

ELECTIVE

January 19, 2012

1. What questions do you ask to assess her sleep quality and quantity?

 In order to develop interventions to improve the amount of quantity and quality of sleep of a patient, a Nurse should have a thorough sleep history. The questions that a nurse should ask the patient include the sleep quality that is described as poor, fair, good or excellent. In terms of sleep quantity, the questions should be about the number of hours the patient is asleep per 24 hours, including daytime naps, bedtime routines, place of sleep, characteristics of the bed, bedding and bedroom environment, food and fluid intake in the evening and at bedtime, use of alcohol and caffeine-containing beverages, medications. The nurse should also include asking the characteristics of the sleep disturbances that the patient experiences and should ask the questions like difficulty of sleeping, difficulty of staying asleep, frequent nocturnal awakenings, early morning awakening and daytime sleepiness. Because you are aware of the drawbacks of the use of hypnotics, what other interventions do you suggest to improve her sleep?  Because it is not always advisable to use sleeping pills and other sedatives because of its drawbacks and side effects, I will recommend the following to my patient in order to improve her sleep; o Minimize or avoid foods that negatively influence sleep like discouraging use of beverages containing stimulants like coffee, tea, sodas in the afternoon and evening, encouraging use of warm milk, providing snacks according to client preference, decreasing fluid intake2-4 hours before bedtime. o Create optimal environment for sleep like keeping noise absolute to a minimum, setting room temperature according to clients preference, providing blankets as requested, using nightlight as desired and providing soft music to mask noise. o Promote physiologic stability like elevating head of bed as required, providing extra pillows per client preference and administering bronchodilators, if prescribed, before bedtime.

Promote comfort by providing analgesia as needed 30 minutes before bedtime, massaging back or feet to help client relax, using warm or cool compresses on painful areas as indicated and assist with progressive relaxation or guided imagery.

2. What sleep disorder do you suspect? What recommendations do you make to your client?

 I suspect that the patient has obstructive sleep apnea because it is more common in older adults and family of the patient is also complaining of patient s loud snoring and choking sounds during his sleep and patient report excessive daytime sleepiness.  I recommend my patient to lose weight, have a proper body positioning during sleep to prevent lying supine and continuous positive airway pressure, also I will discourage client to have a daytime nap and replace it with a stimulating activity.