The nurse is assessing a client in the intensive care unit who is ...

[kellyjaisingh]

The nurse is assessing a client in the intensive care unit who is asleep. What physiological changes will the nurse observe in this client?
 
  1. Lower respiratory rate.
  2. Increased muscle tension.
  3. Increased lower-extremity edema.
  4. Lower blood pressure.
  5. Lower heart rate.

Question 2

A client has not had uninterrupted sleep for several nights, and is irritable. What other assessment findings would the nurse associate with the client's lack of REM sleep?
 
  1. Depression.
  2. Confusion.
  3. Disorientation.
  4. Impaired memory.
  5. Muscle weakness.

[Sammyo]

Answer to Question 1

Correct Answer: 4,5
Rationale 1: A change in respirations is not associated with sleep.
Rationale 2: Skeletal muscles relax during sleep.
Rationale 3: Peripheral blood vessels dilate during sleep, which will reduce lower-extremity edema.
Rationale 4: One physiological change that occurs during sleep is a drop in arterial blood pressure.
Rationale 5: One physiological change that occurs during sleep is a decrease in heart rate.

Answer to Question 2

Correct Answer: 1,2,3,4
Rationale 1: In a sleep-deprived client, the loss of REM sleep causes psychological disturbances such as depression.
Rationale 2: In a sleep-deprived client, the loss of REM sleep causes psychological disturbances such as confusion.
Rationale 3: In a sleep-deprived client, the loss of REM sleep causes psychological disturbances such as disorientation.
Rationale 4: In a sleep-deprived client, the loss of REM sleep causes psychological disturbances such as impaired memory.
Rationale 5: Muscle weakness is not associated with a loss of REM sleep.

[kellyjaisingh]

Excellent

[Missbam101]

TYSM