Definition:
state
in which an individual experiences a change in the quantity or quality
of his rest pattern that causes discomfort or interferes with desired life
style
1. Your initials (required):
2. Defining Characteristics - check those that apply to your client:
None- high
risk diagnosis
difficulty
falling asleep, taking more than 30 minutes to fall asleep
difficulty
remaining asleep, awakens more than 3 times/night
states does not feel rested
awakes earlier
than usual
complains
of fatigue
dozes
during the day
3. Related Factors- check those that apply to your client:
aging related sleep changes
stress, anxiety
pain, discomfort
environmental changes- noise, light etc
dyspnea
nausea
urinary frequency
treatment related- immobility, traction, restraints
awakenings for nursing care
medications
awakening to care of family members (infants, children, aging parents)
4. Goal (ultimate, long term)
5. Outcome Criteria (short term)
6. Evaluation: Was the outcome criteria met?
Yes- Give
Evidence:
No- Explain
how you would change the plan:
7A. Interventions
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5.
6.
7B. Rationale for each intervention
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6.