The client's family remains at the bedside 24 hours a day while the client is in the intensive care unit and contributes to disruptions in the client's sleep. Which does the nurse implement to assist the client with a disrupted sleep pattern?
1. Suggest a hypnotic drug when sleep is interrupted by pain.
2. Discourage the family from visiting during sleeping hours.
3. Avoid turning and positioning the client if sleeping soundly.
4. Plan care with health care team to minimize sleep disruption.
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4. The health care team disrupts client rest frequently in intensive care with activity, noise, lights, and emergencies in addition to the client's care and treatment. To in-crease the quality of sleep and rest, and to promote relaxation, the nurse coordinates care with other disciplines to minimize client interruptions and provides family teaching to promote periods of uninterrupted sleep for the client.
1. A hypnotic can be helpful but should be administered at the beginning of the sleep period because the duration of action is generally 7 to 8 hours. If the medication is given in the middle of the night, the client is likely to feel lethargy until the hypnot-ic's effect wears off.
2. The client and the family determine when the family visits. As long as the client is stable and agency policy allows visiting during the night, the nurse allows the family to visit during sleeping hours, especially if the family is a supportive presence for the client.
4. Turning and positioning can extend high-quality sleep by promoting comfort and preventing pressure points and stiffness. Turning and repositioning is too important to omit for a seriously ill person because impaired skin integrity increases the risk for client infection and tissue loss from pressure ulcers; also, being in the intensive care already exposes the client to a high risk of infection.
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