Sleep Deprivation | Nursing Care Plan for Fecal Diversions

Nursing diagnosis: Sleep Deprivation related to External factors—necessity of ostomy care, excessive flatus or ostomy effluent, Internal factors—psychological stress, fear of leakage of pouch or injury to stoma

Possibly evidenced by
Verbalizations of interrupted sleep, not feeling well-rested
Changes in behavior—irritability, listlessness or lethargy

Desired Outcomes/Evaluation Criteria—Client Will
Sleep
Sleep or rest between disturbances.
Report increased sense of well-being and feeling rested.

Nursing intervention with rationale:
1. Explain necessity to monitor intestinal function in early postoperative period.
Rationale: Client is more apt to be tolerant of disturbances by staff if he or she understands the reasons for, and importance of, care.

2. Provide adequate pouching system. Empty pouch before retiring and, if necessary, on an agreed-upon schedule.
Rationale: Excessive flatus or effluent can occur despite interventions. Emptying on a regular schedule minimizes threat of leakage.

3. Let client know that stoma will not be injured when sleeping.
Rationale: Client will be able to rest better if feeling secure about stoma and ostomy function.

4. Restrict intake of caffeine-containing foods and fluids.
Rationale: Caffeine may delay client’s falling asleep and interfere with REM (rapid eye movement) sleep, resulting in client not feeling well-rested.

5. Support continuation of usual bedtime rituals.
Rationale: Promotes relaxation and readiness for sleep.

6. Determine cause of excessive flatus or effluent and possible actions, such as conferring with dietitian regarding restriction of foods if diet-related.
Rationale: Identification of cause enables institution of corrective measures that may promote sleep or rest.

7. Administer analgesics or sedatives at bedtime, as indicated.
Rationale: Pain can interfere with client’s ability to fall, or remain, asleep. Timely medication can enhance rest or sleep during initial postoperative period. Note: Pain pathways in the brain lie near the sleep center and may contribute to wakefulness.