Varcarolis Chapter 19: Sleep-Wake
Disorders
A client who travels often and therefore experiences jet lag regularly reports the use of
over-the-counter (OTC) melatonin supplements. The nurse responds by informing the client that
melatonin is a naturally secreted hormone and thus is a safe supplement.
research has supported the effectiveness of using melatonin supplements for jet lag.
currently, no standardized, safe therapeutic dosage range for melatonin supplements has been
established.
hypertension is a common side effect of melatonin supplement therapy. - ANScurrently, no
standardized, safe therapeutic dosage range for melatonin supplements has been established.
Because melatonin is an OTC product, the FDA has no input on the identification of effective
dosage ranges or standardization of nutraceutical ingredients.
REF: 376
A non-habit-forming melatonin receptor agonist often prescribed for insomnia is
zolpidem (Ambien).
ramelteon (Rozerem).
eszopiclone (Lunesta).
zaleplon (Sonata). - ANSramelteon (Rozerem).
Ramelteon (Rozerem) is a short-acting melatonin receptor agonist that has been approved by
the FDA for insomnia and is not habit forming.
REF: 376; Table 19-2
According to the National Sleep Foundation, which condition is an example of a social problem
that may be a result of sleepiness?
Narcolepsy
Road rage
,Alcohol abuse
Insomnia - ANSRoad rage
Social problems such as road rage may be caused, in part, by a national epidemic of
sleepiness.
REF: 365-366
A client tells the nurse, "I just don't sleep more than 5 hours at night." The nurse responds best
by asking
"Are you aware that some people require less sleep than others?"
"When did this pattern of sleep start for you?"
"Do you usually feel rested and alert when you get up?"
"Are you taking any medication that could affect your sleep?" - ANS"Do you usually feel rested
and alert when you get up?"
The most accurate way to determine an individual's sleep requirements is to ask if the person
feels fully awake and functions effectively on the sleep he or she is getting.
REF: 368-369
A depressed client is likely to report a sleep disorder that includes
frequent awakenings during the night.
nightmares.
difficulty falling asleep.
sleepwalking. - ANSfrequent awakenings during the night.
Depressed clients often report normal sleep onset, followed by repeated awakenings during the
second half of the night.
REF: 368-369
Medications to treat insomnia are usually prescribed for no longer than
1 to 2 days.
1 to 2 months.
, 3 weeks.
2 weeks. - ANS2 weeks.
Nurses frequently provide education about the benefits of a particular sleep medication, the side
effects, untoward effects, and the fact that medications are usually prescribed for no longer than
2 weeks because tolerance and withdrawal may result.
REF: 376
When providing sleep hygiene information to a client reporting difficulty falling asleep, the nurse
includes
drinking a small amount of alcohol to relax just before bedtime.
taking a short nap after lunch whenever possible.
keeping the bedroom warm to induce coziness.
taking a 20-minute walk after dinner. - ANStaking a 20-minute walk after dinner.
Light, daily exercise often promotes sleep; however, the exercise should not be done right
before bedtime.
REF: 375; Box 19-2
A client tells the nurse that when she was younger, she slept 8 to 10 hours nightly, whereas now
she sleeps only 6 or 7 hours and has to take a nap each afternoon. The nurse can assess that
the client
has a primary sleep disorder.
is suffering from sleep apnea.
has an age-related sleep pattern change.
is displaying signs of sleep deprivation. - ANShas an age-related sleep pattern change.
The older a person gets, the more likely he or she is to have decreased total time sleeping,
even though time in bed is increased. REM sleep is also reduced, and wakefulness during the
night is increased.
REF: 367-368
A client reports to the nurse that falling asleep can often take hours. An appropriate intervention
would be to
Disorders
A client who travels often and therefore experiences jet lag regularly reports the use of
over-the-counter (OTC) melatonin supplements. The nurse responds by informing the client that
melatonin is a naturally secreted hormone and thus is a safe supplement.
research has supported the effectiveness of using melatonin supplements for jet lag.
currently, no standardized, safe therapeutic dosage range for melatonin supplements has been
established.
hypertension is a common side effect of melatonin supplement therapy. - ANScurrently, no
standardized, safe therapeutic dosage range for melatonin supplements has been established.
Because melatonin is an OTC product, the FDA has no input on the identification of effective
dosage ranges or standardization of nutraceutical ingredients.
REF: 376
A non-habit-forming melatonin receptor agonist often prescribed for insomnia is
zolpidem (Ambien).
ramelteon (Rozerem).
eszopiclone (Lunesta).
zaleplon (Sonata). - ANSramelteon (Rozerem).
Ramelteon (Rozerem) is a short-acting melatonin receptor agonist that has been approved by
the FDA for insomnia and is not habit forming.
REF: 376; Table 19-2
According to the National Sleep Foundation, which condition is an example of a social problem
that may be a result of sleepiness?
Narcolepsy
Road rage
,Alcohol abuse
Insomnia - ANSRoad rage
Social problems such as road rage may be caused, in part, by a national epidemic of
sleepiness.
REF: 365-366
A client tells the nurse, "I just don't sleep more than 5 hours at night." The nurse responds best
by asking
"Are you aware that some people require less sleep than others?"
"When did this pattern of sleep start for you?"
"Do you usually feel rested and alert when you get up?"
"Are you taking any medication that could affect your sleep?" - ANS"Do you usually feel rested
and alert when you get up?"
The most accurate way to determine an individual's sleep requirements is to ask if the person
feels fully awake and functions effectively on the sleep he or she is getting.
REF: 368-369
A depressed client is likely to report a sleep disorder that includes
frequent awakenings during the night.
nightmares.
difficulty falling asleep.
sleepwalking. - ANSfrequent awakenings during the night.
Depressed clients often report normal sleep onset, followed by repeated awakenings during the
second half of the night.
REF: 368-369
Medications to treat insomnia are usually prescribed for no longer than
1 to 2 days.
1 to 2 months.
, 3 weeks.
2 weeks. - ANS2 weeks.
Nurses frequently provide education about the benefits of a particular sleep medication, the side
effects, untoward effects, and the fact that medications are usually prescribed for no longer than
2 weeks because tolerance and withdrawal may result.
REF: 376
When providing sleep hygiene information to a client reporting difficulty falling asleep, the nurse
includes
drinking a small amount of alcohol to relax just before bedtime.
taking a short nap after lunch whenever possible.
keeping the bedroom warm to induce coziness.
taking a 20-minute walk after dinner. - ANStaking a 20-minute walk after dinner.
Light, daily exercise often promotes sleep; however, the exercise should not be done right
before bedtime.
REF: 375; Box 19-2
A client tells the nurse that when she was younger, she slept 8 to 10 hours nightly, whereas now
she sleeps only 6 or 7 hours and has to take a nap each afternoon. The nurse can assess that
the client
has a primary sleep disorder.
is suffering from sleep apnea.
has an age-related sleep pattern change.
is displaying signs of sleep deprivation. - ANShas an age-related sleep pattern change.
The older a person gets, the more likely he or she is to have decreased total time sleeping,
even though time in bed is increased. REM sleep is also reduced, and wakefulness during the
night is increased.
REF: 367-368
A client reports to the nurse that falling asleep can often take hours. An appropriate intervention
would be to
