Erica is a 50-year-old woman who developed insomnia around the ...

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Erica is a 50-year-old woman who developed insomnia around the time that she began menopause.
 
  She began treating her insomnia with over-the-counter hypnotics with reasonable success but stopped taking them early this week on the advice of a friend. Erica now describes her insomnia as being worse than ever. The nurse should recognize what factor as the likely cause of her present insomnia?
  A) The fact that she stopped taking hypnotics suddenly rather than gradually
  B) The fact that she did not replace the hypnotic with a different drug prior to stopping the first drug
  C) The fact that her insomnia is attributable to hormonal causes rather than psychosocial factors
  D) The fact that she did not allow enough time to develop a stable serum level of the drug

Question 2

A 60-year-old man is admitted to a hospital with acute coronary syndrome. During the admission assessment, he reveals to the nurse that he has had sleeping difficulties for the past 2 years.
 
  After testing, it is discovered that the patient has sleep apnea. Which of the following would be the primary nursing diagnosis for this patient related to his sleep condition?
  A) Impaired Tissue Perfusion
  B) Readiness for Enhanced Sleep
  C) Disturbed Sleep Patterns
  D) Fatigue

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Answer to Question 1

Ans: A
Feedback:
Hypnotic drugs should usually be tapered down rather than abruptly discontinued. Stopping suddenly may result in rebound insomnia. The lack of a stable serum level and the role of hormonal factors are unlikely to be the cause of this client's current sleep disorder. It would normally be unsafe to take two hypnotics concurrently.

Answer to Question 2

Ans: C
Feedback:
The primary nursing diagnosis of the client with a sleep disorder is Disturbed Sleep Patterns.

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