CHAPTER 8 Sleep and the Older Adult

Chapter 8 Sleep and the Older Adult

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

8.1•Which of the following commonly results from a client experiencing sleep deprivation?

1. development of Alzheimer’s disease
2. fatigue occurring at night
3. visual hallucinations
4. improved healing

Answer: 3

Rationale: The client who is deprived of sleep may experience visual or auditory hallucinations. Sleep deprivation is not known to be a causative factor for Alzheimer’s disease but is known to exacerbate behavioral problems in persons with Alzheimer’s disease. Fatigue may occur but this is during the daytime. Delayed healing is associated with sleep deprivation.

Diagnosis

Physiological Integrity

Analysis

8.2•An older client is discussing problems he has when sleeping. Which of the following statements about sleep and the older adult is correct?

1. An older person does not have as much deep sleep as a younger person.
2. Normally, a person should not awaken more than once during the night.
3. The need for sleep decreases with age.
4. Disrupted sleep is not associated with depression.

Answer: 1

Rationale: Starting at age 20, there is a reduction in slow wave sleep, which is the deepest sleep. This reduction in deep sleep progresses with aging. Waking up three or more times during the night is considered abnormal. Generally, the amount of sleep needed is about the same for the youth, middle-aged, and older adult. The older person may have more difficulty obtaining the quality and quantity of sleep. Many persons with depression report sleep problems, including difficulty getting to sleep, early morning awakenings, and daytime napping.

Diagnosis

Physiological Integrity

Analysis

8.3•A client discusses with the nurse her fears of having sleep apnea. Which of the following statements made by the client is suggestive of sleep apnea?

1. “My legs jump and feel tingly off and on during the night.”
2. “I wake up and feel as if I have been choking.”
3. “I have a great deal of difficulty falling asleep every night.”
4. “I have to sleep on at least three pillows every night.”

Answer: 2

Rationale: The person with sleep apnea, the temporary interruption of breathing during sleep, sleeps with heavy snoring, choking, or struggling to breathe. Sudden muscle contractions with tingling in the legs occur with restless leg syndrome. Difficulty falling asleep is insomnia. Persons with congestive heart failure often must sleep with several pillows to allow the lungs to clear fluid while breathing.

Assessment

Physiological Integrity

Analysis

8.4•An older adult woman states that she has difficulty sleeping. The nurse asks the client for a history of her sleep problems. Which of the following instructions might be included in suggestions to improve her sleep?

1. take several daytime naps if you cannot sleep at night
2. try a glass of wine at bedtime
3. include 10 minutes of moderately strenuous exercise prior to going to bed
4. use the bed only for sleep or sex

Answer: 4

Rationale: Improved sleep hygiene should improve the client’s sleep. The bed should only be used for sleep and sex. Other activities in bed can add to the difficulty with sleeping. Daytime napping interferes with the ability to sleep at night. Alcohol should be avoided because it has been found to disrupt REM sleep, causing awakening from intense dreaming. Exercise should be done early in the day. The hour prior to going to bed should be a calm time in which the body and mind are shutting down and preparing for the onset of sleep.

Intervention

Physiological Integrity

Application