Tuesday, September 17, 2013

Disturbed Sleep Pattern related to Alzheimer's Disease

Nursing Care Plan for Alzheimer's Disease - Nursing Diagnosis : Disturbed Sleep Pattern

Alzheimer's disease is the most common form of dementia. Dementia is a group of symptoms associated with a decline in the way the brain functions, affecting the memory and the way behave. There is no cure for the disease, which worsens as it progresses, and eventually leads to death. Early symptoms are often mistakenly thought to be 'age-related' concerns, or manifestations of stress. In the early stages, the most common symptom is difficulty in remembering recent events.

As the disease advances, symptoms can include confusion, irritability, aggression, mood swings, trouble with language, and long-term memory loss. As the sufferer declines they often withdraw from family and society. Gradually, bodily functions are lost, ultimately leading to death. Since the disease is different for each individual, predicting how it will affect the person is difficult. AD develops for an unknown and variable amount of time before becoming fully apparent, and it can progress undiagnosed for years.

The cause and progression of Alzheimer's disease are not well understood. Research indicates that the disease is associated with plaques and tangles in the brain. There are no available treatments that stop or reverse the progression of the disease.

Because AD cannot be cured and is degenerative, the sufferer relies on others for assistance. The role of the main caregiver is often taken by the spouse or a close relative. Alzheimer's disease is known for placing a great burden on caregivers; the pressures can be wide-ranging, involving social, psychological, physical, and economic elements of the caregiver's life. In developed countries, AD is one of the most costly diseases to society.

Disturbed Sleep Pattern

Time-limited disruption of sleep (natural periodic suspension of consciousness)

Defining Characteristics:

  • Prolonged awakenings;
  • sleep maintenance insomnia;
  • self-induced impairment of normal pattern;
  • sleep onset >30 minutes;
  • early morning insomnia;
  • awakening earlier or later than desired;
  • verbal complaints of difficulty falling asleep;
  • verbal complaints of not feeling well-rested;
  • increased proportion of Stage 1 sleep;
  • dissatisfaction with sleep;
  • less than age-normed total sleep time;
  • three or more nighttime awakenings;
  • decreased proportion of Stages 3 and 4 sleep (e.g., hyporesponsiveness, excess sleepiness, decreased motivation);
  • decreased proportion of REM sleep (e.g., REM rebound, hyperactivity, emotional lability, agitation and impulsivity, atypical polysomnographic features);
  • decreased ability to function


Nursing Diagnosis for Alzheimer's Disease : Disturbed Sleep Pattern related to changes in sensory

Goal: changes in sleep patterns can be resolved client

Outcomes:
  • No changes in behavior and appearance (restless).
  • Able to create adequate sleep patterns with a decrease of the mind hovering (daydreaming).
  • Able to determine the cause of inadequate sleep.

Nursing Interventions:

1. Provide a comfortable environment for improving sleep (turn off the lights, ventilation adequate space, suitable temperature, avoid noise).
R /: Constraints on cortical reticular information will be reduced during sleep, improving the automatic response, thus increasing cardiovascular response to noise during sleep.

2. Encourage exercise during the day and lower mental activity / physical in the afternoon.
R /: Physical activity and mental fatigue that lead to long can increase confusion, which is programmed activities without excessive stimulation increased sleep time.

3. Give afternoon snacks, warm milk, bath, and massage the patient's back.
R /: Improve relaxation with drowsiness.

4. Lower the number of drinks the afternoon. Voiding before bed.
R /: Reduce the need for up to urinate during the night.

5. Encourage clients to listen to soft music.
R /: Lowering the sensory stimulation by blocking other sounds from the surrounding environment that would inhibit sleep.

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