(Select All That Apply):. A nurse is assessing a client's medical history for potential risk factors for sleep and wakefulness disorders. Which of the following are considered medical disorders that can contribute to these disorders? Select all that apply.

Choice A rationale:

Excessive daytime sleepiness is a common consequence of insomnia. This question aims to assess whether the client experiences daytime impairment due to poor sleep initiation or maintenance. Inquiring about excessive daytime sleepiness is crucial because it reflects the potential impact of insomnia on the client's daily functioning.

Choice B rationale:

Asking about whether the client sleeps for more than 9 hours a night is not directly related to insomnia. While prolonged sleep can be seen in certain conditions like hypersomnolence, it doesn't address the core symptom of difficulty initiating or maintaining sleep associated with insomnia.

Choice C rationale:

Inquiring about abnormal respiratory patterns during sleep is relevant for sleep disorders like sleep apnea, which can cause disruptions in sleep due to breathing difficulties. However, this question is not specific to the symptoms of insomnia, which involve difficulties falling asleep or staying asleep.

Choice D rationale:

Asking about falling asleep at inappropriate times during the day is more aligned with narcolepsy, a disorder characterized by sudden and uncontrollable episodes of falling asleep. While some individuals with insomnia might experience daytime sleepiness, it's not a defining feature of the disorder.

Choice A rationale:

Providing the patient with caffeinated beverages in the evening is counterproductive to promoting a safe sleeping environment. Caffeine is a stimulant that can interfere with the ability to fall asleep and stay asleep.

Choice B rationale:

Encouraging the patient to exercise vigorously right before bedtime can actually hinder sleep. Exercise increases alertness and releases adrenaline, making it harder for the body to relax and prepare for sleep. It's recommended to finish vigorous exercise at least a few hours before bedtime.

Choice C rationale:

The correct choice, this action is essential for promoting a safe sleeping environment. Noise and disturbances can disrupt sleep and prevent the patient from achieving restful sleep. Minimizing noise and disturbances can involve measures such as using earplugs, ensuring a comfortable room temperature, and darkening the room to reduce light exposure.

Choice D rationale:

Administering medications to induce sleep at the patient's desired time might lead to dependence on medications for sleep initiation. It's important to address the underlying causes of sleep disorders and use medications judiciously under medical supervision, as stated in Choice D.