A newly admitted patient complains of waking frequently during ...

[pane00]

A newly admitted patient complains of waking frequently during the night. The nurse observes the patient wearing a nicotine patch (Nicoderm CQ) on the right upper arm. Which action is best for the nurse to take?
 
  a. Question the patient about use of the patch at night.
  b. Suggest that the patient go to bed earlier in the evening.
  c. Ask the health care provider about prescribing a sedative drug for nighttime use.
  d. Remind the patient that the benefits of the patch outweigh the short-term insomnia.

Question 2

A patient admitted to the hospital after an automobile accident is alert and does not appear to be highly intoxicated. The blood alcohol concentration (BAC) is 110 mg/dL (0.11 mg). Which action by the nurse is most appropriate?
 
  a. Avoid the use of IV fluids.
  b. Maintain the patient on NPO status.
  c. Administer acetaminophen for headache.
  d. Monitor frequently for anxiety, hyperreflexia, and sweating.

[chreslie]

Answer to Question 1

ANS: A
Insomnia can occur when nicotine patches are used all night. This can be resolved by removing the patch in the evening. The other actions may be helpful in improving the patient's sleep, but the initial action should be to ask about nighttime use of the patch and suggest removal of the patch at bedtime.

Answer to Question 2

ANS: D
The patient's assessment data indicate probable physiologic dependence on alcohol, and the patient is likely to develop acute withdrawal such as anxiety, hyperreflexia, and sweating, which could be life threatening. Acetaminophen is not recommended because it is metabolized by the liver. IV thiamine and IV glucose solutions usually are given to intoxicated patients to prevent Wernicke's encephalopathy, and there is no indication that the patient should be NPO.

[pane00]

Excellent

[helenmarkerine]

Thanks for the timely response, appreciate it