Student Nurses Community

NURSING CARE PLAN Disturbed Sleep Pattern

ASSESSMENT

SUBJECTIVE:
I find it difficult
to sleep at night,
even in the day
especially with all
the interruptions
since Im being
monitored, as
verbalized by the
patient

OBJECTIVE:
Dark circles
under the eyes
Yawning
Restlessness
Irritability
Prolonged

DIAGNOSIS

INFERENCE

PLANNING

Disturbed
sleeping pattern
related to
interruptions for
therapeutics
monitoring, other
generated
awakening, and
excessive
stimulation(noise
and lighting)

Circadian clock
system
(responsible for
regulating sleepwake cycle)

After 24 hours
or nursing
interventions,
patient will be
able to achieve
optimal amount
of sleep as
evidenced by
rested
appearance,
verbalization of
feeling rested
and
improvement in
sleep pattern.

Sleep
homeostasis

alterations of the
circadian
timekeeping
system and/or a
misalignment
between
endogenous
circadian rhythm
and exogenous
factors that affect
sleep timing

INTERVENTIONS

Assess client's
sleep patterns
and usual
bedtime rituals
and incorporate
these into the
plan of care
Observe client's
medication, diet,
and caffeine
intake. Look for
hidden sources
of caffeine, such
as over-thecounter
medications.
Provide
measures to
take before
bedtime to
assist with sleep

RATIONALE

EVALUATIO
N

Usual sleep
patterns are
individual; data
collected through a
comprehensive and
holistic assessment
are needed to
determine the
etiology of the
disturbance

After 24 hours
of nursing
interventions,
goal met.
Patient was
able to project
a rested
appearance,
verbalize
feeling rested
and
demonstrate
improvement
in sleep
pattern.

Difficulty sleeping
can be a side effect
of medications
such as
bronchodilators;
caffeine can also
interfere with
sleep.
Simple measures
can increase
quality of sleep.

Student Nurses Community

awakenings

(interruptions for
therapeutics
monitoring, other
generated
awakening, and
excessive
stimulation(noise
and lighting)

disturbance in
sleep-wake
generating or
timing
mechanisms

Disturbed sleep
pattern

(e.g., quiet time

to allow the
mind to slow
down,
carbohydrates
such as
crackers, or a
back massage)
Assess sleep
pattern
disturbances
that are
associated with
specific
underlying
illnesses
Perform as much
care as possible
without waking
the client, and
do as much care
as possible while
the patient is
still awake
Provide pain
relief shortly
before bedtime
and position
client
comfortably for

Carbohydrates
cause release of
the
neurotransmitter
serotonin, which
helps induce and
maintain sleep.
Research has
shown back
massage to
effectively promote
sleep
High percentage of
sleep disturbances
are affected by
illnesses
To avoid
disturbances during
sleep, and to
maximize sleeping
process
Clients have
reported that
uncomfortable
positions and pain
are common
factors of sleep
disturbance
Excessive noise

Student Nurses Community

sleep
Keep
environment
quiet (e.g., avoid
use of
intercoms, lower
volume on radio
and television,
keep beepers on
non-audio mode,
anticipate
alarms on IV
pumps, talk
quietly on unit)
Explain the
necessity of
disturbances for
monitoring VS
and care when
hospitalized

causes sleep
deprivation that
can result in ICU
psychosis. Health
volunteers exposed
to recorded critical
care noise levels
experienced poor
sleep. It is reported
that more than half
of the noises in
ICUs were caused
by human behavior
such as talking and
TV watching
To promote
understanding of
the importance of
care being done to
the patient