Hospital patients with general medical disorders frequently complain of disturbed sleep. Ensuring that patients have adequate sleep and rest while hospitalized, are important nursing goals to promote patient recovery. Complaints of insomnia require close investigation and are subjective; for example, a patient may blame being fatigued on insomnia, but might be anemic.
Common causes and interventions to help patients sleep:
ACROPARESTHESIA - Improper positioning may compress superficial nerves, disrupting circulation to the compressed nerve. This causes numbness, tingling, and stiffness in an arm or leg. Teach the patient to assume a comfortable position in bed, with his limbs unrestricted. If he tends to awaken with a numb leg or arm, tell him to move it until sensation returns and to assume an unrestricted position.
ANXIETY - Physical and emotional stress produces anxiety, which causes autonomic nervous system stimulation. Encourage the patient to discuss his fears and concerns, and teach him relaxation techniques, such as guided imagery or deep breathing. If ordered, administer a mild sedative such as temazepam or another sedative hypnotic, before bedtime. Emphasize that he should use these medications only for a short time.
DYSPNEA - With many cardiac and pulmonary disorders, a recumbent position causes restricted chest expansion, secretion pooling, and pulmonary vascular congestion, leading to coughing and shortness of breath. Elevate the head of the bed, or provide at least two pillows or a reclining chair to help the patient sleep. Suction him as needed, and encourage deep breathing and inventive spirometry. Also provide supplementary oxygen as ordered.
PAIN - Chronic or acute pain from any cause can prevent or disrupt sleep. Administer pain medication as ordered, 20 minutes before bedtime, and teach deep, even, slow breathing to promote relaxation.
PRURITUS - A localized skin infection or a systemic disorder, such as liver failure, may produce intensely annoying itching, even during the night. Wash the patient’s skin with a mild soap and water, and dry it thoroughly. Apply moisturizing lotion such as calamine lotion on area. Administer diphenhydramine or hydroxyzine as ordered to help minimize itching.
Common causes and interventions to help patients sleep:
ACROPARESTHESIA - Improper positioning may compress superficial nerves, disrupting circulation to the compressed nerve. This causes numbness, tingling, and stiffness in an arm or leg. Teach the patient to assume a comfortable position in bed, with his limbs unrestricted. If he tends to awaken with a numb leg or arm, tell him to move it until sensation returns and to assume an unrestricted position.
ANXIETY - Physical and emotional stress produces anxiety, which causes autonomic nervous system stimulation. Encourage the patient to discuss his fears and concerns, and teach him relaxation techniques, such as guided imagery or deep breathing. If ordered, administer a mild sedative such as temazepam or another sedative hypnotic, before bedtime. Emphasize that he should use these medications only for a short time.
DYSPNEA - With many cardiac and pulmonary disorders, a recumbent position causes restricted chest expansion, secretion pooling, and pulmonary vascular congestion, leading to coughing and shortness of breath. Elevate the head of the bed, or provide at least two pillows or a reclining chair to help the patient sleep. Suction him as needed, and encourage deep breathing and inventive spirometry. Also provide supplementary oxygen as ordered.
PAIN - Chronic or acute pain from any cause can prevent or disrupt sleep. Administer pain medication as ordered, 20 minutes before bedtime, and teach deep, even, slow breathing to promote relaxation.
PRURITUS - A localized skin infection or a systemic disorder, such as liver failure, may produce intensely annoying itching, even during the night. Wash the patient’s skin with a mild soap and water, and dry it thoroughly. Apply moisturizing lotion such as calamine lotion on area. Administer diphenhydramine or hydroxyzine as ordered to help minimize itching.
Related Links:
http://www.wrongdiagnosis.com/symptoms/sleep_symptoms/book-causes-16a.htm
http://rightdiagnosis.co.uk/symptoms/insomnia.htm
Reference:
Lippincott W., Wilkins (2008) Nursing: Interpreting Signs and Symptoms. American Nursing Student, 10(1).
it is very important to ask the patients about their pain level as not only pain disrupts their sleep but also it affects the healing process...
ReplyDeleteevening bath, deep breathing, guided imagery, relaxing music can all help the patient achieve good sleep...
very good list of interventions!