NURSING DIAGNOSIS: Sleep pattern disturbance

related to unfamiliar environment, frequent assessments and treatments, decreased physical activity, fear, anxiety, and inability to assume usual sleep position associated with orthopnea.

Desired Outcome
The client will attain optimal amounts of sleep (see Care Plan on Immobility, Diagnosis 10, for outcome criteria).
Nursing Actions and Selected Purposes/Rationales
  1. Refer to Care Plan on Immobility, Diagnosis 10, for measures related to assessment and promotion of sleep.
  2. Implement additional measures to promote sleep:
    1. perform actions to improve respiratory status (see Diagnosis 2, action b) in order to relieve dyspnea
    2. if client has orthopnea, assist him/her to assume a position that facilitates breathing (e.g. head of bed elevated with arms supported on pillows, resting forward on overbed table with good pillow support, sitting in chair)
    3. maintain oxygen therapy during sleep if indicated
    4. perform actions to reduce fear and anxiety (see Diagnosis 10, action b)
    5. increase activity as allowed and tolerated during the day and early evening.