Asuhan keperawatan

pemenuhan kebutuhan
istirahat dan tidur

Istirahat

Status aktivitas tubuh dlm

keadaan menurun
Keadaan tenang, rileks, bebas
dari cemas dan takut
Bukan situasi restfull

Tidur
Merupakan salah satu kebutuhan
dasar manusia (Maslow, 1970)
Proses universal yg terjadi pd
semua orang
Karakteristik tidur (Hayter, 1980)

Aktivitas fisik minimal

Sadar
Terjadi perubahan fisiologis tubuh
Reson thd stimulus eksternal menurun

Fungsi Tidur
Dikaitkan dg : proteksi dan
restorasi
Everything will look better after a
good nights sleep
Mengembalikan kesegaran fisik
Menurunkan stress dan kecemasan
Mengembalikan kemampuan
konsentrasi dlm aktivitas

Fisiologi Tidur
Pusat pengaturan siklus tidur batang otak
(RES) & BSR (Bulbar Synchronizing Region)
Formasi Retikularis bergerak melalui medulla
pons otak tengah Hipothalamus
Pd keadaan tdr: stimulus dari korteks serebri
dan perifer rendah
Apabila stimulus tinggi terbangun
Formasi retikularis mengatur aktivitas volunter
dan refleks dari stimulus auditori, visual, nyeri
dan tactile
Hipothalamus berfungsi sbg pusat aktivitas
involunter

Perubahan fisik selama

tidur

Penurunan TD arteri
Menurunnya denyut nadi
Dilatasi pembuluh drh perifer
Aktivitas GIT meningkat
(kadang-kadang)
Relaksasi otot skeletal
BMR turun 10 30%

BIORITMIA
Ilmu yg mempelajari irama biologis
tubuh
Diklasifikasikan berdasarkan lamanya
siklus
Irama sirkardiana: siklus satu harian
Irama infrandian: siklus bulanan
menstruasi
Irama ultrasian: siklus lengkap dlm
satu menit atau jam REM saat tdr

TAHAP-TAHAP TIDUR
NREM (Non Rapid Eye Movement)
REM (Rapid Eye Movement)
Alat pemeriksaan:
EEG
EOG
EMG

Pre sleep
NREM tahap I
NREM tahap II

NREM tahap III

REM

NREM tahap IV

NREM tahap II

NREM tahap III

Karakteristik NREM
TAHAP I
Relaxed and drowsy
Propound restfulness
Usually lasts a few minutes
Floating sensation
Eyes roll from side to side
HR,RR dro slightly

Tahap II
Lightly a sleep
Easily aroused
Constitutes 40% to 45% of total sleep time
Lasts only about 10 to 15 minutes
HR, RR drop slightly, temp falls
Tahap III
Less easily aroused
Medium-depth sleep
Muscles totally relaxed
BP lowers
Body temp. lowers

Tahap IV

Factors Affecting Sleep

Ditentukan oleh:
Quality of sleep
Quantity of sleep
Age
Environment
Fatigue
Life-style
Sychological stress
Alcohol and stimulants
Diet
Smoking
Motivation
Illlness

Sleep pattern according to age

Newborn
Sleeps 14 to 18 hours a day
50% REM
Most remaining time spent in stages III
and IV REM
Sleep cycles last 45 to 60 minutes

Infant
Sleeps 12 to 14 hours a day
20 - 30% REM
Sleeps longer at night (8-10 hours) and
has a scheduled attern of naps
At 12 months naps once or twice a day

Toddler

Sleeps 10 to 12 hours a day

25% REM
Most sleep during the night
Midmorning nap decrease
Norma Sleep wake cycles age 2-3 years

Preschooler
Sleeps about 11 hours at night
20% REM
Second nap eliminated by most at age 3
years
At age 5 daytime naps are relinquished

School age child

Sleeps about 10 hours at nigt
18,5% REM
Sleep time remains relatively constant

Adolescent
Sleeps about 8,5 hours a day
20% REM

Young Adult

Most slee 7 to 9 hours a day

20 25 % REM
5 10 % stage I
50% stage II
10 to 20% stage III & IV

Middle-age adult
Sleeps 7 hours a day
20% REM
May have insomnia

Elderly adult

Sleeps about 6 hours a day

20 - 25% REM
Stage IV sometimes absent
First REM eriod is longer
Takes longer to fall sleep

Common sleep disorders

Primer
Insomnia
Hypersomnia
Narcolesy
Sleep apnea
parasomnia