1. Rest & Activity

2. Rest Condition of rest Adequate Sleep Mental Relaxation Physical Comfort

3. Sleep Stages of sleep NREM (non-REM): Stage, REM (rapid eye movement) Sleep cycle

4. Sleep Cycle NREM NREM NREM NREM REM NREM Presleep NREM

5. Assessment of sleep Factors Affecting Sleep Sleep Disorders Sleep Characteristics of Hospitalized Clients Collection of Data About Sleep

6. sleep ageillnessenvironmentfatiguelifestyle Emotional stress Alcohol stimulants dietsmoking Factors Affecting Sleep

7. Sleep characteristics of hospitalized clients Desynchronization sleep deprivation sleep fragmentation vulnerability to rebounds

8. Collection of Data About Sleep Usual sleep pattern Bedtime rituals performed t help fall asleep Use of sleep medications and other drugs Sleep environment Recent changes in sleep patterns or difficulties in sleeping

9. Usual Sleep Pattern hours of undisturbed sleep time of going to bed time of waking up in the morning time and duration of naps time of trying to fall asleep frequency and reason of waking up at night,duration of these periods whether easily aroused and snore sleep disorders insomnia, sleepwalking sleep talking quality of sleep or satisfaction with sleep

10. Nursing Intervention to Promote Sleep Creating a restful environment Supporting bedtime rituals Arranging nursing interventions reasonably Strengthening mental nursing Health teaching Administrating sleep medications reasonably

11. Activity

12. Factors Affecting Activity Growth and Development Physical Health Mental Health Personal Values and Attitudes External Factors Prescribed Limitations

13. Physical Health Congenital or Acquired Postural Abnormalities Problems with Bone Formation or Muscle Development Problems Affecting Joint Mobility Damage to the Central Nervous System Trauma to the Musculoskeletal System Problems Involving other Body Systems

14. Effects of Immobility Musculoskeletal system Disuse atrophy Osteoporosis Contracture Stiffness and pain in the joint Cardiovascular System Orthostatic (postural) hypotension Thrombus formation of deep vein

23. Effects of Immobility Respiratory system Decreased respiratory movement Retention of carbon dioxide Hypostatic pneumonia Metabolic System Decreased metabolic rate Negative nitrogen balance

24. Effects of Immobility urinary system Urinary retention Urinary calculi Urinary infection Gastrointestinal system Constipation Integumentary System Pressure ulcer Psychosocial Effects

25. Activity & Nursing Process

26. Assessing Nursing History Daily activity level Activity tolerance Type and frequency of exercise Factors affecting mobility Physical Examination Problems Related to Immobility

27. Physical Examination Body Alignment and Gait Joint Structure and Function Muscle Mass and Strength Activity Tolerance

28. Assessing general information cardiorespiratory function status Musculoskeletal status Joint function status body activity level current state of illness social and psychological status

29. Implementing Choosing suitable position Maintaining normal physical status of spine and functional position of joints Reducing Immobility Hazards Providing ROM Exercises Implementing isometric and isotonic exercise of muscles