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Rest &
Activity中国医科大学护理学院
吕 岩
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
创建良好的物理环境 满足病人的睡眠习惯,做好就寝前
的准备工作 合理安排护理措施 加强心理护理健康教育指导合理使用药物
Activity
Factors Affecting Activity
生长发育 生理因素 精神心理因素 个体的态度和价值 外界因素 医疗性制动
生 理 因 素 先天或后天的身体畸形 骨骼或肌肉生长问题 影响关节活动性的因素 中枢神经系统的损伤 骨骼肌肉系统的损伤 其他系统的问题
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
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
选择合适的卧位保持脊柱的正常生理弯曲和各关
节的功能位置预防活动受限导致的损害 维持关节的活动性 肌肉的等长练习和等张练习
肌 力 分 级 0 级 完全瘫痪、肌力完全丧失 1 级 可见肌肉轻微收缩但无肢体运动 2 级 肢体可移动位置便不能抬起 3 级 肢体能抬离床面但不能对抗阻力 4 级 能作对抗阻力的运动,但肌力减弱 5 级 肌力正常