The nurse is caring for a client who is having difficulty sleeping in the hospital environment. How can the nurse intervene? (SELECT ALL THAT APPLY)

A. This statement indicates an understanding of hospice care because hospice typically involves discontinuing aggressive treatments such as chemotherapy, radiation, or surgeries that are aimed at curing the cancer. Instead, the focus shifts to palliative care to manage symptoms and improve quality of life.

B. This statement suggests the client may not fully understand hospice care. In hospice, the emphasis is on managing symptoms in the home setting with the support of hospice nurses and caregivers. Calling 911 for symptom management contradicts the philosophy of hospice, which is to avoid aggressive interventions and hospitalizations.

C. This statement indicates a misunderstanding of hospice care. Hospice care focuses on comfort and quality of life rather than rehabilitative services such as physical therapy. In hospice, the care provided is primarily palliative and supportive rather than rehabilitative.

D This statement would indicate a misunderstanding of hospice care. In hospice, the prognosis is typically a life expectancy of six months or less if the disease follows its natural course. Hospice care is provided when curative treatments are no longer effective or desired, and the focus is on comfort rather than prolonging life.

B Watching exciting or stimulating movies, especially horror movies, before bedtime can hinder sleep onset. Such activities can increase arousal and make it more difficult to relax and fall asleep. This statement suggests a lack of understanding of good sleep hygiene practices. Further teaching is needed to discourage stimulating activities before bedtime.

A. Consistency in sleep schedule helps regulate the body's internal clock (circadian rhythm) and can promote better sleep quality. There is no need for further teaching regarding this statement.

C. This statement reflects good sleep hygiene advice. Getting up and engaging in a quiet, boring activity if unable to fall asleep after about 30 minutes can prevent frustration and anxiety associated with lying awake in bed. This practice helps condition the mind to associate the bed with sleep rather than wakefulness. There is no need for further teaching regarding this statement.

D. This statement also reflects good sleep hygiene practices. Going to bed when feeling naturally tired can enhance the ability to fall asleep quickly. It aligns with the concept of associating the bed with sleepiness and promotes sleep onset. There is no need for further teaching regarding this statement.