Eleven months after being treated for breast cancer,a client reports difficulty sleeping and the associated fatigue while denying any other signs/symptoms.The nurse recognizes that the client may be experiencing:

Question

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Survivors' feelings of distress range along a continuum from sadness to disabling depression (Vachon,2006).The long-term presence of fatigue and sleep disturbances,for example,is often associated with anxiety and depression in many cancer survivors (Barton-Burke,2006).
Sleep disorders and fatigue would not necessarily be expected at this point in the remission stage.
Posttraumatic stress disorder (PTSD)is a psychiatric disorder characterized by an acute emotional response to a traumatic event or situation.Cancer survivors experience symptoms of PTSD (e.g. ,grief,nightmares,panic attacks,or fear)at a rate of 4% to 19%,as a result of their diagnosis,treatment,or a past traumatic episode.
While chemotherapy drugs can produce side effects,sleep disorders are not a typical complaint.

Eleven Months After Being Treated for Breast Cancer,a Client Reports