EXERCISE REST & SLEEP.pptx

Fundamentals of nursing

1. Fundamentals of nursing Topic: exercise, rest and sleep Presenter : MACLEANS HANGOMA 1

2. Introduction Exercises can contribute to more sound and restful sleep. Physical activity increases time spent in deep sleep. Chronic sleep deprivation has been shown to increase the risks for mental illness . 2

3. Introduction cont.. Deep sleep helps to boost immune function, support cardiac health and control stress and anxiety Poor sleep and sleep related disorders have had a significant impact on health . 3

4. General objective At the end of the lecture/discussion students should gain knowledge on exercise, rest and sleep 4

5. Specific Objectives At the end of the lesson students should be able to : Define Exercise, Rest and Sleep. Discuss types of exercise. Discuss the importance of exercise Discuss the physiology of sleep. Discuss the stages of sleep. 5

6. Specific Objectives Cont .. Outline the general principles of rest and sleep. Discuss factors affecting rest and sleep. List the measures to promote rest and sleep Outline the rehabilitative measures. 6

7. Definitions Exercise It is a physical or mental activity that you do to stay healthy or to become strong. (WHO, 2019). This is the performance of physical exertion for improvement of health or correction of physical deformity. 7

8. Definitions cont’ Rest Refers to a state of relaxation and calmness, both mental and physical. Activity during rest periods can range from lying down to reading a book to taking a quiet walk. (D’Arcy, 2008). 8

9. Definitions cont’ Sleep Refers to a state of altered consciousness during which an individual experiences minimal physical activity and a general slowing of the body’s physiological processes. 9

10. Types of Exercises Passive Exercises: This is the motion imparted to a segment of the body by another individual, or a machine or other outside forces. Active Exercises: This is the type of exercises a patient can do himself or herself. This is the motion imparted to a part of the body by voluntary contraction and relaxation of its controlling muscles. 10

11. Importance of Exercises Promotes and develops good muscle tone. Stimulates circulation of blood. Prevents complications like deep vein thrombosis. Prevents disability especially in burns. For better body alignment. Prevents constipation by improving and maintaining the tone of the muscles used for defecating. 11

12. Importance of Exercises cont. It promotes the flow of urine and emptying of the bladder. Aids in the prevention of bed sores Prevents postural deformation which may occur due to prolonged joint immobility. Stimulates the nervous system resulting in improved condition and status of the patient. It helps to prevent cardiovascular complications. It meets all human basic needs for movement 12

13. Importance of Rest and Sleep It is essential for the worn out body tissues from activities to restore themselves. Rest facilitates resting of body organs. Sleep reduces stress, anxiety and tension. Helps the person to regain energy for concentration, coping and maintaining interest in daily activities. 13

14. Physiology of Sleep Sleep is a cyclic physiological process that alternates with longer periods of wakefulness. The sleep-wake cycle influences and regulates physiological function and behavioural responses. Current theories indicates sleep is thought to be an active inhibitory process. 14

15. Physiology of Sleep cont.. Control and regulation of sleep may depend on the interrelationship between two cerebral mechanisms that intermittently activates and suppress the brain’s higher centers to control sleep and wakefulness. 15

16. Physiology of Sleep cont.. One mechanism causes wakefulness whereas the other causes sleep. (Cortisol and melatonin). The Ascending reticular Activating System (RAS) located in the upper brain is believed to contain special cells that maintain alertness and wakefulness. The RAS receives visual, auditory, pain, and tactile Sensory stimuli. 16

17. Physiology of Sleep Cont… Activity from the central cortex (e.g. emotions or thoughts process) also stimulates the RAS. Wakefulness results from the neurones in the RAS that releases catecholamine such as norepinephrine. Sleep may be produced by the release of serotonin from specialised cells in the raphe sleep system of the pons and medulla. 17

18. Physiology of Sleep Cont… Whether a person remains awake or falls asleep depends on a balance of impulses received from higher centres (thoughts), peripheral sensory receptors (sound or light stimuli) and the limbic system (emotions). As people try to fall asleep, they close their eyes and assume relaxed positions. Stimuli to the RAS decline. If the room is dark and quiet activation of the RAS further declines. At some points the pons and the medulla takes over causing sleep. 18

19. Fig 1. Reticular activating system (RAS) 19

20. Stages of Sleep Electroencephalograph (EEG) patterns, eye movements, and muscle activity are used to identify stages of sleep. The stages of sleep are classified in two categories: non–rapid eye movement (NREM) and rapid eye movement (REM) sleep. Stage 1. Is very light sleep. The person feels drowsy and relaxed. The sleeper can be readily awakened. This stage lasts for few minutes. 20

21. Stages of Sleep cont.. Stage 2. Light sleep during which the body processes continue to slow down. The eyes are generally still, the heart and respiratory rates decrease slightly, and the body temperature falls. This stage lasts about 10 – 15 minutes. 21

22. Stages of Sleep cont.. Stage 3 . Occurs when the respiratory and the heart rates and other body processes slow down further because of domination of the parasympathetic nervous system. The sleeper becomes more difficult to arouse . 22

23. Stages of Sleep cont.. Stage 4. Signals deep, deep called delta. The sleeper’s heart and respiratory rates are 20 – 30% below waking rates. sleeper is very relaxed, rarely moves, and is difficult to arouse. During this stage the eyes usually roll and some dreaming occur. 23

24. General Principles of Rest and Sleep Procedures in the ward should be done at once to avoid disturbance of the patient. Tension should be eased by adequate explanation given to the patient before any procedure is done. Noise should be avoided. Limit the number of Visitors 24

25. General Principles of Rest and Sleep cont’ Physical comfort should be provided to the patient by ensuring the following:- Relive pain Empty the bladder before sleep Changing of positioning Provide dim lighting Proper ventilation on the ward. Provide adequate warmth. Maintain hygiene for instance brushing teeth before bed time 25

26. Factors affecting Rest and Sleep Illness: - increases the need for sleep, but disease often disrupts normal sleep rhythms. Environmental factors: - can either enhance or impair sleep. Lighting, temperature, odors, ventilation, and noise level can all interrupt the sleep process when they differ from the norms of the client’s usual sleep environment. Emotional stress:- Anxiety often results in difficulty falling asleep or staying asleep 26

27. Factors affecting Rest and Sleep cont’ Diet: - type of food consumed has an impact on the quality and quantity of sleep. Foods high in caffeine, such as coffee, cola, and chocolate, serve as stimulants and often disrupt the normal sleep cycle. A large, heavy, or spicy meal just before bedtime may cause indigestion, which will likely interfere with sleep. Conversely, going to bed when hungry can also result in sleep problems 27

28. Factors affecting Rest and Sleep cont’ Lifestyle ;- having a work schedule that does not coincide with an individual’s biological clock (e.g., working at times other than the day shift). Individuals who frequently change work shifts have a real challenge trying to stabilize biological rhythms and rest. 28

29. Factors affecting Rest and Sleep Cont… Drugs and Other Substances :-Alcohol and nicotine use can impair sleep. Small amounts of alcohol may help some people fall asleep; however, in others alcohol may interfere with REM sleep, causing very restless and non-refreshing sleep. Nicotine, which is a stimulant, can also impair the sleep cycle by stimulating the body, resulting in difficulty falling and staying asleep 29

30. Factors affecting Rest and Sleep Cont… Many medications (both prescription and over the counter) cause fatigue, sleepiness, restlessness, agitation, or insomnia, thus affecting the quality and quantity of rest and sleep. Cultural: - some patient fears the hospital environment as stranger (procedures, light, and uniform for nurse). Cultural or ethnic customs may have an impact on a client’s ability to achieve rest and sleep. 30

31. Factors affecting Rest and Sleep Cont… Degree of Comfort- Comfort is a highly subjective experience. The nurse must assess the degree to which the client’s physical and psychological needs have been met. Whenever basic needs are unmet, the person experiences discomfort, which leads to physiological tension, resultant anxiety, and potential impairments in sleep and rest. 31

32. Recommended hours of sleeping Neonate (birth to 1 month) sleeps in 3 to 4 hour intervals for a total of about 16 to 20 hours a day. Infant (1month to 2 years) averages about 12 to 16 hours of sleep a day with naps 2 to 3 times during the day. Toddlerhood (2 to 3 years) average sleep is 12 to 14 hours at night with 1 to 2 naps during the day. 32

33. Recommended hours of sleeping cont’ Pre-school child (4 to 6 years) sleeps approximately 10 to 12 hours a day. Daytime napping decreases or ceases, unless cultural norms dictate otherwise. School-age child (7-8years) sleep 10 to 12 hours of sleep daily Adolescents sleep about 8 to 10 hours a day and often decide their bedtime routines and hours. Middle-age adult sleeps about 6 to 8 hours a day Older adult - sleeps 5 to 7 hours a day . 33

34. Measures to Promote Rest and Sleep Eliminate noise Patients should not be hungry, provide a snack where possible, for instance a glass of milk. Give water to patients who may need it at night for instance full the jugs and put them within reach of patient. Prepare the patient by giving a bedpan or urinal. Blankets should be adequate for warmth because, a well-made and clean bed promotes sleep. 34

35. Measures to Promote Rest and Sleep cont’ Prescribed medications should be given early to help patients sleep for instance analgesics for pain. Tell the patient to be free to ask for help. Give the patient a soothing bath. Reading or watching a movies. 35

36. Rehabilitative measures sleep can be enhanced by the following measures; Encourage client to establish a bed time routine and a regular sleep pattern to help induce sleep. Clients should limit intake of caffeine, nicotine and alcohol before bed time because they are stimulants and may cause difficulties in falling asleep, and alcohol fragment sleep. 36

37. Rehabilitative measures cont’ Clients should avoid stressful concerns before bed time because this may stimulate them and prevent sleep. They should adjust the environment, that is controlling noise, temperature and lighting in the bed room to provide a conducive environment to sleep Clients should avoid exercises 2-3hours before bed time because they stimulates the client and prevent sleep. 37

38. Summary We have come to the end of our Lecture/ Discussion. We have defined exercise as a physical or mental activity that you do to stay healthy or to become strong; Rest as a state of relaxation and calmness, both mental and physical. Activity during rest periods can range from lying down to reading a book to taking a quiet walk and Sleep as a state of altered consciousness during which an individual experiences minimal physical activity and a general slowing of the body’s physiological processes. 38

39. Summary cont.. We have also discussed about the importance of the rest and sleep which facilitates resting of body organs. The principles of sleep such as never go to sleep with an empty stomach, full bladder or after a heavy fatty meal. Sleep pattern is regulated by the diencephalon structures and the reticular activating system and we further discussed on the four stages of sleep, factors that affect sleep such as emotional stress. 39

40. Evaluation What is exercise, rest and sleep? What are the types of exercises? What is the importance of exercises? What is the importance of sleep? What are the principles of rest and sleep? What measures can be carried out to promote rest and sleep? 40

41. Assignment What are the factors that influence rest and sleep? Due next class 41

42. References Ramont, Niedringhaus, Towle. (2006). Comprehensive Nursing Care , 5 th edition. Santa Ana California Corinthian College Inc. Patricia K. Ladner, DeLaune .C. (2008). Fundamentals of Nursing Standards & Practice 4 th Edition. William Carey University United Kingdom. World Health Organization (2019). Physical Activity . 42