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Assessment Diagnosis Inference Planning Interventions Rationale Evaluation

Subjective:

“I nd it dicult to

sleep at nigt!

even in te da"

especiall" #it all

te interruptions

since I$m being

monitored!% as

verbali&ed b" te

patient

'bjectives:

Dar( circles

under te e"es

 )a#ning

Restlessness

Irritabilit"

Prolonged

a#a(enings

Disturbed

sleeping pattern

related to

interruptions forterapeutics

monitoring! oter

generated

a#a(ening! and

e*cessive

stimulation+noise

and ligting,

-ircadian cloc(

s"stem

+responsible for

regulating sleep.#a(e c"cle,

Sleep omeostasis

alterations of te

circadian

time(eeping

s"stem and/or a

misalignment

bet#eenendogenous

circadian r"tm

and e*ogenous

factors tat a0ect

sleep timing

+interruptions for

terapeutics

monitoring! oter

generated

a#a(ening! and

e*cessive

stimulation+noiseand ligting,

After 12 ours or

nursing

interventions!

patient #ill beable to acieve

optimal amount of 

sleep as

evidenced b"

rested

appearance!

verbali&ation of

feeling rested and

improvement in

sleep pattern3

Assess client4s

sleep patterns

and usual

bedtime ritualsand

incorporate

tese into te

plan of care

'bserve

client4s

medication!

diet! and

ca0eine inta(e3

5oo( foridden sources

of ca0eine!

suc as over.

te.counter

medications3

Provide

measures to

ta(e before

bedtime to

assist #it

sleep +e3g3!

6uiet time to

7sual sleep

patterns are

individual8 data

collected trouga compreensive

and olistic

assessment are

needed to

determine te

etiolog" of te

disturbance

Dicult" sleeping

can be a side

e0ect ofmedications suc

as

broncodilators8

ca0eine can also

interfere #it

sleep3

Simple measures

can increase6ualit" of sleep3

-arbo"drates

cause release of

After 12 ours of

nursing

interventions! goal

met3 Patient #asable to project a

rested

appearance!

verbali&e feeling

rested and

demonstrate

improvement in

sleep pattern3

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disturbance in

sleep.#a(e

generating or

timing

mecanisms

Disturbed sleep

pattern

allo# te mind

to slo# do#n!

carbo"drates

suc as

crac(ers! or a

bac( massage,

Assess sleep

pattern

disturbances

tat are

associated

#it specic

underl"ing

illnesses

Perform asmuc care as

possible

#itout #a(ing

te client! and

do as muc

care as

possible #ile

te patient is

still a#a(e

Provide pain

relief sortl"

before bedtime

te

neurotransmitter

serotonin! #ic

elps induce and

maintain sleep3

Researc as

so#n bac(massage to

e0ectivel"

promote sleep

9ig percentage

of sleep

disturbances are

a0ected b"

illnesses

 o avoid

disturbances

during sleep! and

to ma*imi&e

sleeping process

 

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and position

client

comfortabl" for

sleep

;eepenvironment

6uiet +e3g3!

avoid use of

intercoms!

lo#er volume

on radio and

television!

(eep beepers

on non.audio

mode!

anticipate

alarms on I<pumps! tal(

6uietl" on unit,

E*plain te

necessit" of

disturbances

for monitoring

<S and care#en

ospitali&ed

-lients ave

reported tat

uncomfortable

positions and pain

are common

factors of sleepdisturbance

E*cessive noise

causes sleep

deprivation tat

can result in I-7

ps"cosis3 9ealt

volunteers

e*posed to

recorded critical

care noise levels

e*perienced poor

sleep3 It is

reported tat

more tan alf of

te noises in I-7s

#ere caused b"

uman beavior

suc as tal(ing

and < #atcing

 o promote

understanding of

te importance of

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care being done

to te patient