The nurse in the assisted living facility notices that a resident ...

[segrsyd]

The nurse in the assisted living facility notices that a resident seems to be restless most nights and sits in the lounge area reading. When questioned, the client reports suffering from insomnia.
 
  The resident tells the nurse this is not a big deal.. Which of the following does the nurse expect as an outcome if the client continues with this pattern of sleep? 1. The nurse is concerned about the liability created by a resident who is unsupervised in the lounge areas.
   2. The nurse recognizes that insomnia is linked to cardiac dysfunction if it is not managed.
   3. The nurse is aware that the client's ability to adequately function during the day may be hindered by these episodes.
   4. The nurse is concerned that the client is demonstrating significant underlying problems.

Question 2

The nurse is communicating with a primary care provider about medical interventions prescribed for a client. Which statement is the best example of appropriate assertive communication by the nurse?
 
  1. That new medication you prescribed for the client is ineffective..
   2. I am worried about the client's blood pressure. It remains high even with the new medication..
   3. Can we talk about this client?
   4. Excuse me, Doctor, I think you need to do something about the client's blood pressure..

[cswans24]

Answer to Question 1

3. The nurse is aware that the client's ability to adequately function during the day may be hindered by these episodes.

Rationale:
Insomnia is defined as an inability to fall asleep or stay asleep on most nights for over a month. The individual experiencing insomnia is at risk for daytime drowsiness and may experience problems with concentration and function. Insomnia is not a cause for liability; it is up to the nurse to make sure that hospitalized clients are safe, but they cannot be restricted from moving about. There is no evidence that insomnia leads to cardiac problems. There is no evidence that the client is demonstrating underlying problems.

Answer to Question 2

2. I am worried about the client's blood pressure. It remains high even with the new medication..

Rationale:
The nurse who expresses concern because the client's blood pressure remains high on new medication is being assertive, clear, and concise. Telling the physician that the new medication is ineffective is an inflammatory remark to the doctor. Asking if the physician can talk about a client does not give the physician enough information. Stating that the physician must do something about a client's blood pressure may produce defensiveness from the physician.