Asuhan keperawatan Asuhan keperawatan pemenuhan kebutuhan pemenuhan kebutuhan

istirahat dan tiduristirahat dan tidur

Istirahat Istirahat

Status aktivitas tubuh dlm Status aktivitas tubuh dlm keadaan menurunkeadaan menurun

Keadaan tenang, rileks, bebas Keadaan tenang, rileks, bebas dari cemas dan takutdari cemas dan takut

Bukan situasi restfullBukan 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 night’s 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%

BIORITMIAIlmu yg mempelajari irama biologis tubuhDiklasifikasikan 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 TIDURTAHAP-TAHAP TIDUR NREM (Non Rapid Eye Movement)NREM (Non Rapid Eye Movement) REM (Rapid Eye Movement)REM (Rapid Eye Movement)Alat pemeriksaan:Alat pemeriksaan: EEGEEG EOGEOG EMGEMG

Pre sleepPre sleep

NREM tahap INREM tahap I

NREM tahap II NREM tahap II NREM tahap IIINREM tahap III

REMREM NREM tahap IVNREM tahap IV

NREM tahap IINREM tahap II NREM tahap IIINREM tahap III

Karakteristik NREMKarakteristik NREM

TAHAP ITAHAP I Relaxed and drowsyRelaxed and drowsy Propound restfulnessPropound restfulness Usually lasts a few minutesUsually lasts a few minutes Floating sensationFloating sensation Eyes roll from side to sideEyes roll from side to side HR,RR dro slightlyHR,RR dro slightly

Tahap IITahap II Lightly a sleepLightly a sleep Easily arousedEasily aroused Constitutes 40% to 45% of total sleep timeConstitutes 40% to 45% of total sleep time Lasts only about 10 to 15 minutesLasts only about 10 to 15 minutes HR, RR drop slightly, temp fallsHR, RR drop slightly, temp fallsTahap IIITahap III Less easily arousedLess easily aroused Medium-depth sleepMedium-depth sleep Muscles totally relaxedMuscles totally relaxed BP lowersBP lowers Body temp. lowersBody temp. lowers

Tahap IVTahap IV

Factors Affecting SleepFactors Affecting SleepDitentukan oleh:Ditentukan oleh: Quality of sleepQuality of sleep Quantity of sleepQuantity of sleep AgeAge EnvironmentEnvironment FatigueFatigue LLiife-stylefe-style Sychological stressSychological stress Alcohol and stimulantsAlcohol and stimulants DietDiet SmokingSmoking MotivationMotivation IlllnessIlllness

Sleep pattern according to ageSleep 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 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 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 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 childSchool age child

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

Adolescent Adolescent

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

Young AdultYoung 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