Rest - a condition in which body is in decreased state of activity

Sleep – state of rest accompanied of level of consciousness and inactive.

STAGES OF SLEEP

NREM sleep – Nonrapid eye movement (4 stages)

Stage 1- lightest level of sleep, last few minutes, daydreaming has occurred.
Stage 2 – period of sound sleep, relaxation progress, arousal is still easy, last 10-20 minutes.
Stage 3 – initial stages of deep sleep, lasts 15-30 minutes
Stage 4 – very difficult to arouse sleeper, deepest stage of sleep, lasts 15-30 minutes, sleep walking
and enuresis may occur.

REM sleep – Rapid Eye Movement

Vivid full color dream may occur, gastric secretions increase, very difficult to arouse, duration
increased with each cycle and averages 20 minutes.

ADEQUATE REST AND SLEEP ARE IMPORTANT IN:

Promoting general health
Ensuring recovery from illness
Aid healing process
Increase ability to learn and concentration
Help person to be socially adaptable.

FACTORS THAT AFFECT SLEEP

Physical illness
Drugs and substances
Lifestyle
Emotional stress
Environment
Exercise and fatigue
Food and caloric intake

SLEEP AND REST DISTURBANCES WILL IMPLY:

Irritable, anxiety and stress

Fatigue
Reduce work optimally
Seek assistance from physicians
Poor concentration
Difficulty making decisions

NORMAL SLEEP PATTERNS

Newborn: 16-18 hrs a day
Infants: some 22 hrs, and others 12-14 hrs
Toddlers: 10-12 hrs
Preschool: 11-12 hrs
School-Age: 8-12 hrs
Adolescents: 8-10 hrs
Adult: 6-8 hrs
Elders: 6 hrs

SLEEP DISORDERS

Insomnia
chronic difficulty falling asleep (initial insomnia)
difficulty remaining asleep (intermittent insomnia)
inability to go back to sleep after awakening (terminal insomnia)

SLEEP APNEA
disorder in which the individual cannot breathe and sleep at the same time.
three types: central, obstructive, and mixed

CENTRAL SLEEP APNEA

caused by cessation of diaphragmatic and intercostal respiratory effort result in disfunction of the
brain
impulse to breathe fails, temporarily.
least common form

OBSTRUCTIVE APNEA
most common form
cessation of airflow despite the effort to breath.
occurs when muscles or structured of the oral cavity or throat relax during sleep.
loud snoring.

NARCOLEPSY
a CNS dysfunction pf mechanism that regulate the sleep and wake states
falls asleep uncontrollably at inappropriate times.
treated with stimulants

SLEEP DEPRIVATION
S/S blurred vision, fine motor clumsiness, decreased reflexes, slowed response time.
Psychological S/S: confusion, disorientation, increased sensitivity to pain, irritable.

PARASOMNIAS
sleep problem that are common in the children, one common exemption is bruxism (tooth grinding)
Somnambulism (sleep walking)
Nightmares
Nocturnal enuresis (bedwetting)

ENVIRONMENTAL FACTORS AFFECTING COMMON AND SLEEP

Comfortable room temperature
Proper Ventilation
Minimal noise
Comfortable bed
Proper lighting
PROMOTING BEDTIME ROUTINES
help client to relax in preparation for sleep
avoid mental simulations before bedtime
relaxation exercises
guided imagery
good sleep hygiene

SLEEP HYGIENE
avoid heavy meals 3 hrs before bed time
avoid sleeping long hours during weekends.

PROMOTING COMFORT
encourage client to wear loose-fitting nightwear
keep bed linen dry

ACTIVITY
If client is at home, encourage physical activity during daytime

CONTROL OF NOISE IN HOSPITAL

close doors to clients room and work areas.
avoid loud noises
keep necessary conversations at low levels.

DEFENITION OF TERMS

COMMUNICATION
process of transmitting thoughts, feelings, facts, and other information.

SUBJECTIVE DATA
Consists of statement or complaint mode by the client
OBJECTIVE DATA
Factual or measurable in some way.

COMMUNICATION PROCESS

SENDER (ENCODER) – first component of communication process, person who generates a message.
MESSAGE – what is written or said, the body language that accompanies the words.
CHANNEL – the medium through which a message is transmitted.
THREE MAJOR COMMUNICATION CHANNELS
Visual Channel – consist of sight and observation
Auditory Channel – consists of spoken words and cues
Kinesthetic Channel – refers to experiencing sensations.
RECEIVER – the person who interprets the senders message
INFLUENCED BY:
physiological – hearing, eyesight
psychological – anxiety
cognitive process – “thinking”
FEEDBACK – the information the sender receives about the receivers reaction to the message.

MODES OF COMMUNICATION

1. Verbal Message – are messages communicated through words and language, either spoken or
written.
NEED TO BE CONSIDERED:
Pace and intonation – the manner of speech, as in the pace or rhythm at intonations.
Simplicity – includes the use of commonly understood words.
Clarity – saying precisely what is meant
Brevity – using the fewest words necessary.
Timing and relevance – timing is critical in communication, messages are relevant and important.
Adaptability – spoken messages need to be altered in accordance with the behavioral cues.
Credibility – means worthiness of belief, trust worthiness, and reliability.
Humor – used to help clients adjust from difficult and painful situations.

2. Nonverbal messages – are messages communicated without words, that is, through body
language.
Facial Expression – give clues that support, contradicts and disguise the verbal messages.
Posture and gait – forms of self-expression, the way people talk and carry themselves.
Hand movement and gestures- like faces, hands are expensive they can communicate feelings at any
given time.
Eye contact – making eye contact during conversations shows respect and willingness to listen.

1. Ability of the communicator – persons ability to speak, hear, see and comprehend.
2. Perception – each person has a unique personality traits, values, and life experiences.
3. Personal Space – distance people prefer in interaction with others.
PROXEMICS – the study of distances between people in their interactions.

Intimate zone – 12 inches to less, space reserved for personal intimacy.

Personal Zone – 1-2 feet, reserved for people we know and like, or those we invite in.
Social zone – 2p4 feet, space is far enough away that we feel comfortable with this those we don’t
know well.
Public zone – more than 4 feet, space outside your personal zone where your comfort is not a factor.
4. Territoriality – the concept of space and things that are individual considers as belonging to the
self.
5. Roles and relationship – between sender and receiver affect the communication process.
6. Time- factor of communication includes the event that precedes and follow the interaction.
7. Environment – people communicate with effectively in a comfortable environment.
8. Attitudes – convey beliefs, thoughts and feelings about people and event.
9. Emotions and Self Esteem – affects the persons ability to interpret the message.

TYPES OF COMMUNICATION

1. THERAPEUTIC COMMUNICATION – use communication for the purpose of creating a beneficial

outcome for the client.
TECHNIQUES
Offering self – nurse is available physically and emotionally.
Silence – gives client time to reflect, encourage client to express self.
Open-ended comments – unfinished sentences that prompt client to continue.
Reflection – focuses on content of client’s messages and feelings
Restarting – indicates nurse is listening to client. Repeating or paraphrasing client’s main idea.
Focusing – questions or statements that help client develop or expand an idea.
Providing general leads – using statements or questions that encourage the client to verbalize,
choose a topic for conversation, facilitate continued verbalization.
Using touch – providing appropriate forms of touch to reinforce caring healing.
Restation or paraphrasing – actively listening for the patients basic messages.
Seeking Clarifications – method of making the broad overall meaning of the message.
Acknowledging – giving recognition in a nonjudgmental way.
Clarifying time or sequence – helping the client clarify and event or situation.
Presenting Reality – helping the client differentiate from real to unreal.
Summarizing/ planning – stating the main points of the discussions.

2. Non therapeutic Communication – interferes with effective communication

Stereotyping – responses categorize client and negate their uniqueness as individuals.
Agreeing and disagreeing – implies that the patient is either right or wrong .
Being defensive – attempting to protect a person or health care services from negative comments.
Challenging – these responses indicate that the nurse is failing to consider the clients feelings.