Cues and Clues Subjective: Reported no problems falling asleep but reported instances of being awakened late at night.

. Verbalized di ako makatulog dahil ang ingay ng mga kotse sa labas Objective: Observed lack in energy Restlessness Observed frequent yawning.

Nursing Diagnosis Disturbed sleep pattern r/t environmental factors.

Rationale Disturbed sleep pattern is defined as a sustained disruption in amount and quality of sleep that impairs functioning. Environmental factors such as noise can disrupt the clients sleep.

Objectives At the end of 5 hours of nursing interventions the patient will be able to: 1. Verbalize understanding of sleep impairment. 2. Identify individually appropriate interventions to promote sleep. At the end of 1 week of nursing interventions the patient will be able to: 1. Report improvement in sleep/rest pattern 2. Report increased sense of well-being and feeling rested

Nursing intervention 1. Assess sleep pattern disturbances that are associated with the environment. 2. Observe and obtain feedbacks regarding on the usual sleeping pattern, bedtime routine and the usual number of hours of sleep and rest. 3. Note caffeine and alcohol intake 4. Listen to subjective reports of sleep quality 5. Provide quiet environment and comfort measures 6. Discuss/implement effective ageappropriate bedtime rituals 7. Recommend limiting intake of chocolate and caffeine/alcoholic beverages, especially prior to bedtime. 8. Explore other sleep aids (warm bath/milk) 9. Encourage participation in regular exercise program during day

Rationale 1. High percentage of sleep disturbances can affect the recovery of the patient. 2. To determine usual sleeping pattern and to compare if there are any improvements on the sleeping pattern of the patient. 3. May interfere with falling asleep/quality of sleep 4. Provides opportunity to address misconceptions/unrealistic expectations and plan for interventions 5. Promotes relaxation and readiness for sleep 6. To enhance clients ability to fall asleep 7. Substances known to impair falling asleep or staying asleep. 8. Nonpharmaceutical aids may enhance falling asleep free of concern of medication side effects such as morning hangover or drug dependence 9. to aid in stress control/release of energy

Evaluation At the end of 5 hours of nursing interventions the patient was able to: 1. Verbalize understanding of sleep impairment. 2. Identify individually appropriate interventions to promote sleep. At the end of 1 week of nursing interventions the patient was able to: 1. Report improvement in sleep/rest pattern 2. Report increased sense of wellbeing and feeling rested