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Disturbed Sleep Pattern Assessment Guide

The document outlines a nursing assessment and intervention plan for a patient experiencing disturbed sleep patterns related to auditory hallucinations. It includes subjective and objective data, a diagnosis, and specific interventions aimed at improving the patient's sleep quality and emotional well-being. The evaluation indicates that the patient showed improvement in sleep and daytime activities after the interventions were implemented.

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Rovic Gasmen
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7 views2 pages

Disturbed Sleep Pattern Assessment Guide

The document outlines a nursing assessment and intervention plan for a patient experiencing disturbed sleep patterns related to auditory hallucinations. It includes subjective and objective data, a diagnosis, and specific interventions aimed at improving the patient's sleep quality and emotional well-being. The evaluation indicates that the patient showed improvement in sleep and daytime activities after the interventions were implemented.

Uploaded by

Rovic Gasmen
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION EVALUATION

And
RATIONALE
Subjective Data:
Disturbed After 8 hours, INDEPENDENT: After 8 hours of
“putol-putol ang Sleeping the Patient nursing
tulog ko at may Pattern will be able 1. Build a therapeutic interventions, the
napanaginipang Related to to report rapport. Establish trust patient was able
about construction” Auditory feeling rested through nonjudgmental to show
as stated by the hallucination, and show communication and improvement in
patient. as evidenced improvement active listening. his sleeping
by agitated in sleep/ rest problem. GOAL
“may bumubulong and pattern. Rationale: Because trust MET
sa akin na lalaki restlessness. fosters a secure and
habang natutulog encouraging Patient was able
ako” as stated by environment where to perform
the patient. patients feel Daytime activities.
comfortable sharing GOAL MET
“maaga siyang their ideas and feelings,
nakatulog kagabi it is crucial for effective
pero nung nagising communication and
hindi na makatulog” teamwork during the
as verbalized by the therapeutic process.
mother.

2. Give the patient's


Objective Data: emotions validation
without encouraging
- Restlessnes inappropriate conduct.
s noted
- Agitated Rationale: By accepting
- Dark circles the patient's emotional
under eyes experience and avoiding
- Frequent maladaptive behaviors,
change of validation aids in
mood noted emotional self-
- V/S taken as acceptance and lessens
follows feelings of loneliness by
T: 36.6 °C stopping harmful
P: 105 bpm patterns from recurring.
R: 17 bpm
BP: 120/80 mmHg
3. Assess past patterns
of sleep in a normal
environment: amount,
bedtime rituals, length,
depth, position, aids,
and interfering agents.

Rationale: Sleep
patterns are unique to
each individual

4. Instruct the patient to


follow a consistent daily
schedule for retiring and
arising as possible.
Rationale: This
promotes regulation of
the circadian rhythm,
and reduces the energy
required for adaptation
to changes.

5. Instruct the patient to


avoid including caffeine
in the meal as well as
heavy meal.

Rationale: Gastric
digestion and
stimulation from
caffeine can disturb
sleep.

6. Encouraged patient to
increase daytime
activities.

Rationale: Daytime
activities increase the
body’s need for rest,
leading to a stronger
sleep drive at night.

INDEPENDENT:

7. Document nursing or
caregiver observations
of sleeping and wakeful
behaviors. Record the
number of sleep hours.

Rationale: Often, the


patient’s perception of
the problem may differ
from objective
evaluation.

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