Author Question: The nurse is evaluating outcomes for the patient with insomnia. Which key principle will the nurse ... (Read 29 times)

magmichele12 · **on:** Jul 22, 2018

The nurse is evaluating outcomes for the patient with insomnia. Which key principle will the nurse consider during this process?

a. The patient is the best evaluator of sleep.
b. The nurse is the best evaluator of sleep.
c. Effective interventions are the best evaluators of sleep.
d. Observations of the patient are the best evaluators of sleep.

Question 2

The nurse is preparing an older-adult patient's evening medications. Which treatment will the nurse recognize as relatively safe for difficulty sleeping in older adults?

a. Ramelteon (Rozerem)
b. Benzodiazepine
c. Antihistamine
d. Kava

mirabriestensky · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

ANS: A
With regard to problems with sleep, the patient is the source for evaluating outcomes. The patient is the only one who knows whether sleep problems have improved and what has been successful. Interventions are not the best indicator; achievement of goals according to the patient is the best. Observations do provide needed data, but in the case of insomnia, the patient is the source for evaluating the restfulness of sleep.

Answer to Question 2

ANS: A
Ramelteon (Rozerem), a melatonin receptor agonist, is well tolerated and appears to be effective in improving sleep by improving the circadian rhythm and shortening time to sleep onset. It is safe for long- and short-term use particularly in older adults. The use of benzodiazepines in older adults is potentially dangerous because of the tendency of the drugs to remain active in the body for a longer time. As a result, they also cause respiratory depression, next-day sedation, amnesia, rebound insomnia, and impaired motor functioning and coordination, which leads to increased risk of falls. Caution older adults about using over-the-counter antihistamines because their long duration of action can cause confusion, constipation, and urinary retention. Kava promotes sleep in patients with anxiety; it should be used cautiously because of its potential toxic effects on the liver.