Mental Health Assessment

8. List the nursing implications and education needs for each of the following categories of medication related to heart failure: See Attached

Sleep is important not only for promoting healing, but also for the overall well-being of the individual. When there are problems with the sleeping pattern, it impacts the overall health and safety of the older adult. The person will not have enough rest and will be too tired to perform activities surrounding daily living. We have to assess the risk factors contributing to the problems of sleep disturbance and these might be “related to poor sleep hygiene, including an irregular sleep schedule, environmental noise or light, and the use of stimulants” (Mauk, 2014, p. 581). If the sleeping pattern is not assessed, possible complications will happen, such as falls that could lead to bodily injuries.

According to the study, the behaviors can either be reduced or limited to certain times of the day. For example, avoid drinking caffeinated drinks within 2 hours of bed so that you do not disrupt your body’s metabolism. Other activities that interfere with sleep are frequent napping, spending excessive time in bed, having variable bedtimes and different wake-times. Also, activities such as taking stimulants near bedtime hours, use of the bed for non-sleep related activities, poor bedroom environment and engaging in stimulating activities near bedtime may disrupt one from sleeping early. By avoiding these activities, I will improve my sleep hygiene which will translate to getting enough

There is quite a singificant psychological component here with some psychophysiological insomnia related to his underlying anxiety. Moving forward, treatment of this will be of paramount importance. Alongside this, there are some sleep hygiene strategies that he can work on and we have discussed these in detail and I have given him some written information for this. Alongside this, we have also started discussion about a sleep study to assess whether or not there is any other underlying sleep disorder that could be contributing to his sleep difficulties and also his unrefreshing sleep even on nights when he is sleeping

Medical: Wellness Coach asked Mr. Hallet how was his day and he said he was doing well. He also express that he been taking his medication but the sleep pills is causing to have irregular patterns of sleep. Mr. Hallet has been falling to sleep everywhere even while traveling on public transportation. He also stated that the sleep pills are causing him to even fall asleep during the work hours. Wellness Coach and Family Counselor Clair Arzon discuss with Mr. Hallet that maybe creating sleep pattern will then decrease the irregular sleeping. He express that he has tried everything. Family Counselor Ms. Arzon inform Mr. Hallet to try not taking the sleeping pills for a few days to see how his sleep habits will be. If he gets sleepy then to take walks or drink water to help keep Mr. Hallet up during the day and when bedtime come try turning the TV off therefore you can relax.

Sleep consultation was performed by a physician specialized in sleep disorders. Patients underwent comprehensive medical history and complete physical examination. All subjects completed the Epworth Sleepiness Scale (ESS) within few days of the sleep study. The ESS is a self-administrated questionnaire that asks subjects to rate how likely they would have dozed (fallen asleep) in 8 specific situations or activities that are commonly met in daily life. The chance of dozing is rated on a scale of 0-3 (0 = would never dose, 1 = slight chance of dozing, 2 = moderate chance of dozing, and 3 = high chance of dozing). The total ESS score is the sum of 8-items scores and can range between 0 and 24. The higher

To determine internal homogeneity, the researchers found Cronbach’s alpha to be 0.83, which demonstrates a high degree of internal consistency. They analyzed both individual items and the seven component scores, each of which demonstrated strong correlations with one another. To determine test-retest reliability, the researchers used paired t-tests to analyze the global PSQI score and the seven individual component scores. The results demonstrated no differences between the t-test values. Each of the scores were significantly correlated, demonstrating stability in the questionnaire. Validation of the PSQI was determined by looking at the significance of the global PSQI scores via ANCOVA with respect to age and sex as covariates. Age was found to be a significant covariate in the daytime dysfunction component, while sex was found to be a significant covariate in the sleeping medications and habitual sleep efficiency component. The sensitivity of the questionnaire as found to be 89.6% and the specificity was found to be 86.5%. To further validate the PSQI, researchers compared it to variables of sleep obtained via PSG. The PSQI and PSG showed similar scores for sleep latency; however the PSQI overestimates the past month’s sleep duration and efficiency. Overall, the PSQI is a valid measurement tool that demonstrated: (1) subjects and patients can easily use it;

Philip was seen today as ongoing management of his sleep difficulties. Very pleasingly with the help of Frank Cahill, sleep psychologist, and a significant reduction in his life’s stressors, his sleep is much better and he is sleeping very well from about 11.00pm to 6.30am. He is still waking slightly unrefreshed and of note, his most recent sleep study did reveal borderline obstructive sleep apnoea which is predominantly in supine sleep. Given this we have discussed a positional modification device which he will go ahead and trial.

Tom is described by his mother to be a sound sleeper for the first 3 hours and usually falls asleep around 8PM watching television in her room. His father then transfers him to his own bed. However, between the hours of 12AM and 3AM Tom usually wakes up to use the bathroom on occasion he wets the bed. Some nights he experiences sleep talking as well as sleep walking and on those days he has a difficult time waking up at 8AM to get ready for

The individual does not have any trouble remaining awake throughout daily activities and she is always very enthusiastic. Based on this information, the Pittsburg Sleep Quality Index score she received was a five which would describe her as a poor sleeper. The sleep apnea machine, the epidural, and the pills she sometimes takes help her have a better quality of sleep. She has found ways to sleep an appropriate amount of hours, which may be considered a good sleeping

My family and I would sometimes joke about my step father sleeping hours on in the day until he was rushed to the hospital for not breathing while he was sleep. This was a wakeup call for my entire family because we realized we had no idea on how to help him. I was curious to know what we could do to help him get normal eight hours of sleep and not suffer from sleep. I also wanted to help families that may can relate to my situation and help them as well. Anyone who knows someone who struggles with sleeping disorders know how difficult it is seeing a love one not getting enough rest or getting too much rest that can cause them to be hospitalized.

Description: Follow-up after a full-night in lab sleep study performed to evaluate him for daytime fatigue and insomnia. This patient presents with history of sleep disruption and daytime sleepiness with fatigue. His symptoms are multifactorial.

Based on the result of the PSQI, Ms. R. experiences high quality and good pattern of sleep. Overall, she scored 2 in the PSQI Global Index. Of the seven components in the sleep assessment tool, she scored 0 in five areas, and rated two areas with one’s. In component #5, she rated letter (e) with a three (3), which she further explained that snoring is a regular occurrence. The other two areas in component #5 that were rated with one’s (1’s )were letters (a) and (b): waking up in the middle of the night or early morning and feeling too hot. There was only one area that she scored 2 = cannot get to sleep within 30 minutes.

The first evaluation was a polysomnography sleep study. Which involves measurements of multiple physiological parameters by a combination of electroencephalography, electrocardiography, electromyography, electrooculography, pneumography and pulse oximetry to measure sleep worthiness and sleep efficiency (Meltzer & Mindell, 2006). The polysomnography recorded the participant’s brain waves, the oxygen level in their blood during sleep, heart rate and breathing, as well as any eye and leg movements during the time of the study. Statistically significant polysomnographic findings will show lower sleep efficiency, higher apnea–hypopnea index (AHI) and a larger number of sleep stage shifts per hour in the children, determining the quality of sleep each participant is experiencing (Meltzer & Mindell, 2006) as being good or bad. Subjects were rated to have good sleep, if Rapid Eye Movement (REM) sleep stage was

Lying among tousled sheets, eluded by sleep with thoughts racing, many people wrestle with the nightly demon named insomnia. Insomnia is defined as, "the perception or complaint of inadequate or poor-quality sleep because of one or more of the following: difficulty falling asleep, waking up frequently during the night with difficulty returning to sleep, waking up too early in the morning, or unrefreshing sleep" (Rajput 1431). Because the definition of "poor-quality sleep" is not the same for every person, it is not easy to determine the frequency and severity of it's occurrence (Holbrook 216). To add to the complexity of this problem, there is not even one universal treatment that can be used effectively in all cases. Many