Author Question: A client with a history of insomnia has been taking chlordiazepoxide (Librium), 15 mg, at night for ... (Read 74 times)

hubes95 · **on:** Jul 19, 2018

A client with a history of insomnia has been taking chlordiazepoxide (Librium), 15 mg, at night for the past year. The client currently reports that this dose is no longer helping him fall asleep.

Which nursing diagnosis appropriately documents this problem? A. Ineffective coping R/T unresolved anxiety AEB substance abuse
B. Anxiety R/T poor sleep AEB difficulty falling asleep
C. Disturbed sleep pattern R/T Librium tolerance AEB difficulty falling asleep
D. Risk for injury R/T addiction to Librium

Question 2

A client diagnosed with depression and substance use disorder has an altered sleep pattern and demands that a psychiatrist prescribe a sedative.

Which rationale explains why a nurse should encourage the client to first try nonpharmacological interventions? A. Sedative-hypnotics are potentially addictive and will lose their effectiveness due to tolerance.
B. Sedative-hypnotics are expensive and have numerous side effects.
C. Sedative-hypnotics interfere with necessary REM (rapid eye movement) sleep.
D. Sedative-hypnotics are not as effective to promote sleep as antidepressant medications.

lkanara2 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

C
Tolerance is defined as the need for increasingly larger or more frequent doses of a substance in order to obtain the desired effects originally produced by a lower dose.

Answer to Question 2

A
The nurse should recommend nonpharmacological interventions to this client because sedative-hypnotics are potentially addictive and will lose their effectiveness due to tolerance. The effects of central nervous system depressants are additive with one another and are capable of producing physiological and psychological dependence.