CLIENT TEACHING Promoting Sleep - Pearson Education

1 CHAPTER 45 / Sleep 1177 Examples of NOC outcomes and NIC interventions to assistclients with Sleep disturbances are shown in Identifying NursingDiagnoses, Outcomes, and Interventions. Specific nursing activ-ities associated with each of these interventions can be selectedto meet the individual needs of the CLIENT . See the nursing CarePlan and Concept Map at the end of the hygieneis a term referring to interventions used to pro-mote Sleep . nursing interventions to enhance the quantity andquality of clients Sleep involve largely nonpharmacologicmeasures. These involve health TEACHING about Sleep habits,support of bedtime rituals, the provision of a restful environ-ment, specific measures to promote comfort and relaxation, andappropriate use of hypnotic hospitalized clients, Sleep problems are often related tothe hospital environment or their illness.

2 Assisting the CLIENT tosleep in such instances can be challenging to a nurse, often in-volving scheduling activities, administering analgesics, andproviding a supportive environment. Explanations and a sup-portive relationship are essential for the fearful or anxiousclient. Different types of hypnotics may be prescribed depend-ing on the type of Sleep problem ( , difficulties falling asleepor difficulties maintaining Sleep ). Drugs with longer half-livesare often prescribed for difficulties maintaining Sleep , but mustbe used with caution in the TeachingHealthy individuals need to learn the importance of Sleep inmaintaining active and productive lifestyles. They need to learn(a) the conditions that promote Sleep and those that interferewith Sleep , (b) safe use of Sleep medications, (c) effects of otherprescribed medications on Sleep , and (d) effects of their diseasestates on Sleep .

3 CLIENT TEACHING for Promoting Sleep is shown inClient Bedtime RitualsMost people are accustomed to bedtime rituals or presleep rou-tines that are conducive to comfort and relaxation. Altering oreliminating such routines can affect a CLIENT s Sleep . Commonprebedtime activities of adults include listening to music, read-ing, taking a soothing bath, and praying. Children need to be so-cialized into a presleep routine such as a bedtime story, holdingonto a favorite toy or blanket, and kissing everyone is also usually preceded by hygienic routines, such aswashing the face and hands (or bathing), brushing the teeth, institutional settings, nurses can provide similar bedtimerituals assisting with a hand and face wash, providing a mas-sage or hot drink, plumping of pillows, and providing extrablankets as needed.

4 Conversing about accomplishments of theday or enjoyable events such as visits from friends can also helpto relax clients and bring peace of a Restful EnvironmentAll people need a sleeping environment with minimal noise, acomfortable room temperature, appropriate ventilation, and ap-propriate lighting. Although most people prefer a darkened en-vironment, a low light source may provide comfort for childrenor those in a strange environment. Infants and children need aCLIENT TEACHINGP romoting SleepSLEEP PATTERN If you have difficulty falling asleep or staying asleep, it is importantto establish a regular bedtime and wake-up time for all days of theweek to enhance your biological rhythm. A short daytime nap ( ,15 to 30 minutes), particularly among elders, can be restorativeand not interfere with nighttime Sleep .

5 A younger person with in-somnia should not nap. Establish a regular, relaxing bedtime routine before Sleep such asreading, listening to soft music, taking a warm bath, or doing someother quiet activity you enjoy. Avoid dealing with office work or family problems before bedtime. Get adequate exercise during the day to reduce stress, but avoidexcessive physical exertion at least 3 hours before bedtime. Use the bed for Sleep or sexual activity, so that you associate it withsleep. Take work material, computers, and TVs out of the awake, tossing and turning, will strengthen the associationbetween wakefulness and lying in bed (many people with insom-nia report falling asleep in a chair or in front of the TV but havingtrouble falling asleep in bed). When you are unable to Sleep , get out of bed, go into anotherroom, and pursue some relaxing activity until you feel Create a Sleep -conducive environment that is dark, quiet, comfort-able, and cool.

6 Keep noise to a minimum; block out extraneous noise as neces-sary with white noise from a fan, air conditioner, or white noise ma-chine. Music is not recommended as studies have shown thatmusic will promote wakefulness (it is interesting and people willpay attention to it). Sleep on a comfortable mattress and Avoid heavy meals 2 to 3 hours before bedtime. Avoid alcohol and caffeine-containing foods and beverages ( ,coffee, tea, chocolate) at least 4 hours before bedtime. Caffeinecan interfere with Sleep . Both caffeine and alcohol act as diuretics,creating the need to void during Sleep time. If a bedtime snack is necessary, consume only light carbohydratesor a milk drink. Heavy or spicy foods can cause gastrointestinal up-sets that disturb Use sleeping medications only as a last resort.

7 Use over-the-counter medications sparingly because many contain antihista-mines that cause daytime drowsiness. Take analgesics before bedtime to relieve aches and pains. Consult with your health care provider about adjusting other med-ications that may cause CLIENT with Difficulty Falling Asleep Case 11/8/06 6:24 PM Page 1177