A client who has had excellent symptom reduction as a result of ...

[Kikoku]

A client who has had excellent symptom reduction as a result of taking a conventional/standard
  antipsychotic tells the nurse that his medication makes him so sleepy that he is concerned his
  supervisor may terminate his employment.
 
  A solution the nurse should discuss with the physician is
  a. reducing the dose by half.
  b. discontinuing the medication.
  c. having the client take the medication at bedtime.
  d. switching from the conventional antipsychotic to risperidone (Risperdal).

Question 2

The client's nursing diagnosis is disturbed sleep pattern related to anxiety. The desired outcome is
  that the client will sleep for a minimum of 5 hours nightly by October 31 .
 
  On November 1 sleep data
  show the client sleeps an average of 4 hours nightly and takes a 2-hour afternoon nap. After the
  evaluation, the nurse should
  a. leave the care plan unchanged.
  b. remove the nursing diagnosis from the care plan.
  c. write a new nursing diagnosis that better reflects the problem and its cause.
  d. extend the time in which the goal is to be accomplished and examine
  interventions.

[mmj22343]

Answer to Question 1

ANS: C
Taking the medication at bedtime when the sedation would not be problematic may also reduce
daytime sleepiness. Option A might prompt symptom exacerbation. Option B is undesirable because
it may prompt relapse. Option D would not resolve the problem because risperidone also produces
sedation.

Answer to Question 2

ANS: D
Sleeping a total of 5 hours at night is still a reasonable outcome. Extending the time frame for
attaining the outcome is appropriate. Examining interventions might result in planning an activity
during the afternoon rather than permitting a nap. Option A is inappropriate. At the very least, the
time in which the outcome is to be attained must be extended. Option B could be used when the
outcome goal has been met and the problem resolved. Option C is inappropriate because no other
nursing diagnosis relates to the problem.

[Kikoku]

TYSM

[Dinolord]

Excellent