The nurse is assessing an older client who wakes up during the night. Which finding does the nurse identify as the greatest risk factor for disturbed sleep?

Question

1. Client has osteoarthritis of both hips.
2. Client drinks two cups of coffee per day.
3. Client takes antidepressant medication in the morning.
4. Client leaves the television on all day and night.

Answer 1

1. Client has osteoarthritis of both hips.

Explanation: 1. A common source of pain in older adults is the chronic pain resulting from osteoarthritis. It can result in chronic sleep disruption for older people.
2. Limiting caffeine intake to one to two cups of coffee per day should not interrupt sleep. If the client prefers coffee late in the day or more than two cups total during the day, the nurse assesses for caffeine tolerance and makes suggestions accordingly.
3. Some antidepressants have stimulating effects and should be taken in the morning. The nurse assesses the client for evidence of sleepiness from the antidepressant and makes suggestions accordingly.
4. Bright lights and noises can disrupt sleep. Some clients find comfort in and are used to continual TV, so this is something the nurse assesses further.