Rest &

Activity

Rest

Condition of rest Adequate Sleep Mental Relaxation Physical Comfort

Sleep Stages of sleep

NREM (non-REM):

Stage , Ⅰ Ⅱ ，Ⅲ，Ⅳ

REM (rapid eye movement) Sleep cycle

Sleep Cycle

NREMⅡ

REM

NREMⅡ

NREMⅢ

NREMⅣ

NREMⅢ

Presleep NREMⅠ

Assessment of sleep

Factors Affecting Sleep Sleep Disorders Sleep Characteristics of

Hospitalized Clients Collection of Data About Sleep

smoking

diet

Alcohol

stimulants

Emotional stress lifestyle

fatigue

environment

illness age

sleep

Factors Affecting Sleep

Sleep characteristics of hospitalized clients

Desynchronization

昼夜性节律去同步化sleep deprivation 睡眠减少sleep fragmentation 睡眠中断vulnerability to rebounds

诱发补偿

Collection of Data About Sleep

Usual sleep pattern Bedtime rituals performed t help fall

asleepUse of sleep medications and other

drugsSleep environment Recent changes in sleep patterns or

difficulties in sleeping

Usual Sleep Pattern

hours of undisturbed sleep time of going to bed time of waking up in the morning time and duration of naps time of trying to fall asleep frequency and reason of waking up at

night ,duration of these periodswhether easily aroused and snoresleep disorders ： insomnia,

sleepwalking ， sleep talking quality of sleep or satisfaction with sleep

Nursing Intervention to Promote Sleep

Creating a restful environment Supporting bedtime rituals Arranging nursing interventions

reasonably Strengthening mental nursing Health teaching Administrating sleep medications

reasonably

Activity

Factors Affecting Activity

Growth and Development Physical Health Mental Health Personal Values and Attitudes External Factors Prescribed Limitations

Physical Health

Congenital or Acquired Postural Abnormalities

Problems with Bone Formation or Muscle Development

Problems Affecting Joint Mobility Damage to the Central Nervous System Trauma to the Musculoskeletal System Problems Involving other Body Systems

Effects of Immobility

Musculoskeletal system Disuse atrophy 废用性肌萎缩 Osteoporosis 骨质疏松 Contracture 挛缩 Stiffness and pain in the joint 关节僵硬、疼痛Cardiovascular System Orthostatic (postural) hypotension 体位性低血压 Thrombus formation of deep vein 深静脉血栓形成

Effects of Immobility

Respiratory system

Decreased respiratory movement

Retention of carbon dioxide

二氧化碳滞留 Hypostatic pneumonia 坠积性肺炎Metabolic System Decreased metabolic rate

Negative nitrogen balance

Effects of Immobility

urinary system Urinary retention 尿潴留 Urinary calculi 泌尿道结石 Urinary infection 泌尿道感染Gastrointestinal system Constipation 便秘Integumentary System Pressure ulcer

Psychosocial Effects

Activity &

Nursing Process

Assessing Nursing History Daily activity level

Activity tolerance

Type and frequency of exercise

Factors affecting mobility

Physical Examination Problems Related to Immobility

Physical Examination

Body Alignment and Gait Joint Structure and Function Muscle Mass and Strength Activity Tolerance

Assessing

general information 一般资料 cardiorespiratory function status 心肺功能状

态 Musculoskeletal status 骨骼肌肉状态 Joint function status 关节功能情况 body activity level 机体活动能力 current state of illness 目前的患病情况 social and psychological status 社会心理状况

Implementing

Choosing suitable position Maintaining normal physical status of

spine and functional position of joints Reducing Immobility Hazards Providing ROM Exercises Implementing isometric and isotonic

exercise of muscles