Sleep Pattern Disturbance
Sleep Pattern Disturbance
(_)Actual (_) Potential
| (_) Impaired oxygen transport (_) Impaired elimination (_) Impaired metabolism (_) Immobility (_) Medication (_) Hospitalization | (_) Lack of exercise (_) Anxiety response (_) Life-style disruptions (_) Other:_____________________________ ____________________________________ ____________________________________ |
| Major: (Must be present) | (_) Difficulty falling or remaining asleep |
| Minor: (May be present) | (_) Fatigue on awakening or during the day (_) Dozing during the day (_) Agitation (_) Mood alterations |
| Date & Sign. | Plan and Outcome [Check those that apply] | Target Date: | Nursing Interventions [Check those that apply] | Date Achieved: |
| The patient will: (_) Demonstrate an optimal balance of rest and activity A.E.B. ___ hours of uninterrupted sleep at night. (_) Remain awake during the day. (_) Other: | (_) Explore with patient potential contributing factors. (_) Maintain bedtime routine per patient preference.
(_) Takes sleeping pill as ordered by a physician @ ____ pm. (_) Provide comfort measures to induce sleep:
(_) Limit nighttime fluids to:________ (_) Void before retiring. (_) Coordinate treatment/meds to limit interruptions during sleep period. (_) Limit the amount and length of daytime sleeping:____________ (_) Increase daytime activity:______ (_) Other:________________ |
__________________________
Patient/Significant other signature
__________________________
RN signature
Friday, May 16, 2008
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Labels:
care plan
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