NR 226 Exam 2: Sleep, Fluid and Electrolytes – Nursing Fundamentals Review
and Practice Questions
sleep - ✔✔an altered state of consciousness where perception of and reaction to environment
is decreased
sleep deprivation - ✔✔condition of not having enough sleep, can be either chronic or acute
chronic sleep deprivation - ✔✔restricted state can cause fatigue, daytime sleepiness,
clumsiness and weight gain, adversely affects the brain and cognitive function
sleep pattern disturbance - ✔✔due to decreased physical activity, fear, anxiety, inability to
assume usual sleep position, frequent assessments or treatments, unfamiliar environment, and
discomfort resulting from current illness/injury
circadian rhythms - ✔✔biological clock, synchronized to light-dark cycles, and cues in
organisms environment, going to bed at the same time every night
sleep regulation - ✔✔regulated by a sequence of physiological states integrated by CNS
activity
stages of sleep - ✔✔1,2,3,4 and REM
sleep cycle - ✔✔once asleep a person passes through 4 to 5 sleep cycles
stage 1: NREM - ✔✔lightest level of sleep, lasts a few minutes, decreased physiological activity
beginning with a gradual fall in vital signs and metabolism, person easily aroused by sensory
stimuli such as noise, in person awakes, feels as though daydreaming has occurred, reduction in
a autonomic activities,
, stage 2: NREM sleep - ✔✔period of sound sleep, relaxation progresses, arousal still easy, lasts
10 to 20 minutes, body functions still slowing, at this stage, you might want to leave them
sleeping, if it is possible try not to wake them up for vital sign checks or other routine testing
stage 3: NREM - ✔✔initial stages of deep sleep, sleeper difficult to arouse and rarely moves,
muscles completely relaxed, vital signs decline but remain regular, lasts 15 to 30 minutes,
hormonal response includes secretion of growth hormone (especially in children in stage 3 &4)
stage 4: NREM - ✔✔deepest stage of sleep, very difficult to arouse sleeper, if sleep loss has
occurred, sleeper will spend considerable portion of night in this stage, VS are significantly
lower than during waking hours, stage last approx. 15-30 minutes, sleepwalking and enuresis
sometimes occur
REM sleep - ✔✔stage of vivid, full-color dreaming, first occurs approx, 90 minutes after sleep
has begun, thereafter occurs at end of each NREM cycle, typified by autonomic response of
rapidly moving eyes, fluctuating heart and respiratory rates, and increased fluctuating blood
pressure, loss of skeletal muscle tone, responsible for mental restoration, stage in which sleeper
is most difficult to arouse, duration of REM sleep increases with each cycle and averages 20
minutes
functions of sleep - ✔✔restores normal levels of activity, restores normal balance among parts
of the nervous system, necessary for protein synthesis (energy for body and muscle growth),
psychological well-being , dreams
purpose of sleep - ✔✔physiological and psychological restoration and maintenance of
biological functions
dreams - ✔✔occur in NREM and REM sleep and important for learning, memory and
adaptation to stress
and Practice Questions
sleep - ✔✔an altered state of consciousness where perception of and reaction to environment
is decreased
sleep deprivation - ✔✔condition of not having enough sleep, can be either chronic or acute
chronic sleep deprivation - ✔✔restricted state can cause fatigue, daytime sleepiness,
clumsiness and weight gain, adversely affects the brain and cognitive function
sleep pattern disturbance - ✔✔due to decreased physical activity, fear, anxiety, inability to
assume usual sleep position, frequent assessments or treatments, unfamiliar environment, and
discomfort resulting from current illness/injury
circadian rhythms - ✔✔biological clock, synchronized to light-dark cycles, and cues in
organisms environment, going to bed at the same time every night
sleep regulation - ✔✔regulated by a sequence of physiological states integrated by CNS
activity
stages of sleep - ✔✔1,2,3,4 and REM
sleep cycle - ✔✔once asleep a person passes through 4 to 5 sleep cycles
stage 1: NREM - ✔✔lightest level of sleep, lasts a few minutes, decreased physiological activity
beginning with a gradual fall in vital signs and metabolism, person easily aroused by sensory
stimuli such as noise, in person awakes, feels as though daydreaming has occurred, reduction in
a autonomic activities,
, stage 2: NREM sleep - ✔✔period of sound sleep, relaxation progresses, arousal still easy, lasts
10 to 20 minutes, body functions still slowing, at this stage, you might want to leave them
sleeping, if it is possible try not to wake them up for vital sign checks or other routine testing
stage 3: NREM - ✔✔initial stages of deep sleep, sleeper difficult to arouse and rarely moves,
muscles completely relaxed, vital signs decline but remain regular, lasts 15 to 30 minutes,
hormonal response includes secretion of growth hormone (especially in children in stage 3 &4)
stage 4: NREM - ✔✔deepest stage of sleep, very difficult to arouse sleeper, if sleep loss has
occurred, sleeper will spend considerable portion of night in this stage, VS are significantly
lower than during waking hours, stage last approx. 15-30 minutes, sleepwalking and enuresis
sometimes occur
REM sleep - ✔✔stage of vivid, full-color dreaming, first occurs approx, 90 minutes after sleep
has begun, thereafter occurs at end of each NREM cycle, typified by autonomic response of
rapidly moving eyes, fluctuating heart and respiratory rates, and increased fluctuating blood
pressure, loss of skeletal muscle tone, responsible for mental restoration, stage in which sleeper
is most difficult to arouse, duration of REM sleep increases with each cycle and averages 20
minutes
functions of sleep - ✔✔restores normal levels of activity, restores normal balance among parts
of the nervous system, necessary for protein synthesis (energy for body and muscle growth),
psychological well-being , dreams
purpose of sleep - ✔✔physiological and psychological restoration and maintenance of
biological functions
dreams - ✔✔occur in NREM and REM sleep and important for learning, memory and
adaptation to stress
