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NUR 257 Chronic Exam 4 Fall 2025/2026 | Galen College of Nursing Chronic Conditions Exam

HEAL100 Health Care — exam and revision material · Other

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Health Care exam material, 30 pages. Originally published on StudyMerit.

Pages
30
Academic year
2025/2026
Language
English

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Exam 4 Healthy Rest, Sleep & Activity Biorhythm Changes & Changes in Sleep – Box 13.2  Less responsive to light → irregular sleep-wake cycle  ↓ melatonin, ↓ REM, lighter sleep  Daytime sleepiness/napping, frequent awakenings, trouble falling asleep  ↑ frequency of abnormal leg movements & abnormal breathing  Poor sleep → not normal, indicator of health status → assess! Risk Factors for Sleep Disturbances – Box 13.3  Comorbidities (CVD, diabetes, pain, Parkinson’s, dementia, GERD, etc.)  Polypharmacy  Lack of exercise  Poor sleep hygiene, excessive napping, sleep disorders  Anxiety, depression, stress  Environment (noises, institutional routines, limited sunlight, etc.) Medications affecting sleep – Box 13.4 SSRI’s , antihypertensives, anticholinergics , diuretics , opiates, cold meds, steroids, levodopa, thyroid meds . Sleep disorders Insomnia Difficulty falling or staying asleep ≥ 1 month w/ daytime impairment.  Safety Alert : Falls Risk  Symptoms: difficulty initiating & maintaining sleep, premature morning awakening, non-restorative sleep  Techniques to enhance sleep: sleep hygiene education, daily walking, ↑ light exposure during day, ↓ light & noise at night Sleep Apnea messages.downloaded_by lOMoARcPSD|6879242

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Stop breathing while sleeping, episodes stop with arousal.  Symptoms: snoring, gasping, fragmented sleep, morning HA, memory issues, daytime sleepiness, irritability  Risks – Box 13.8 : age, male, ↑ neck circumference, obesity, upper airway abnormalities, family hx, alcohol/sedatives, smoking  Tx: weight loss, avoid alcohol/smoking, side-sleep, CPAP Restless Leg Syndrome Sensorimotor neurologic disorder characterized by unpleasant leg sensations that disrupts sleep  Symptoms: creeping/crawling sensations relieved by movement, tingling, cramping, pain/burning pain  Aggravated by antidepressants & neuroleptic meds  Tx: stretching, hot baths, relaxation techniques, avoid alcohol Rapid Eye Movement Sleep Behavior Disorder Loss of voluntary muscle atonia during REM sleep → violent behaviors while dreaming (punching or kicking)  Seen in: Parkinson’s, Lewy body, Alzheimer’s, progressive supranuclear palsy  Tx: clonazepam & safety measures Circadian Rhythm Sleep Disorders Normal sleep occurs at abnormal times (2 types)  Advanced sleep phase disorder (ASPD): sleep early o Tx: sleep hygiene, delay timing of sleep & wake, bright light therapy 1 to 2 hours daily  Irregular sleep-wake disorder (ISWD): scattered sleep o Tx: ↑ light exposure during day, avoid exposure to bright lights during night. Assessment Review : sleep habits/patterns, sleep disturbances/contributing factors Sleep Diary – Box 13.5  Record 2 to 4 weeks messages.downloaded_by lOMoARcPSD|6879242

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 Record when they: go to bed, go to sleep, wake up, get out of bed, nap, exercise/physical activity, consume alcohol or caffeine, night routine Self-rating scales  Pittsburg Sleep Quality Index → quality & patterns of sleep  Epworth Sleepiness Scale → daytime sleepiness Test : Polysomnography in sleep lab Promoting Sleep & Insomnia interventions Nonpharmacologic FIRST (1 ST line Tx): sleep hygiene, CBT, relaxation, daytime light exposure Healthy Sleep Habits – Box 13.7  Consistent sleep schedule & night routine, 7 hours of sleep, no napping  Don’t go to bed unless sleepy, can’t fall asleep after ≤ 20 min → out of bed  Bedroom → relaxing & quiet, comfortable room temp  Limit exposure to bright lights/loud noise in evening  Turn off electronics 30 min before bed  If hungry at night, eat a light snack  Avoid caffeine/alcohol in afternoon/evening  ↓ fluid intake before bed Pharmacologic Treatment  Use w/ caution in older adults!  Can use melatonin – 1-2 hours before bed  Avoid benzodiazepines or other sedative-hypnotics! Activity Health Benefits of Physical Activity – Box 13.9  ↓ HTN, CAD, MI, diabetes, colon & breast cancers, metabolic syndrome, depression, adverse blood lipid profile  Improves weight, sleep, mobility, bone health, functional independence, strength, cardiorespiratory fitness, prevents falls Exercise Guidelines – Box 13.12 messages.downloaded_by lOMoARcPSD|6879242

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