Author Question: A client diagnosed with insomnia, triggered by anxiety, is prescribed paroxetine (Paxil). When the ... (Read 71 times)

Anajune7 · **on:** Jul 23, 2018

A client diagnosed with insomnia, triggered by anxiety, is prescribed paroxetine (Paxil). When the client asks the nurse why an antidepressant has been prescribed, which response by the nurse is the most appropriate?

1. Paxil is a sedativehypnotic that will enhance sleep.
2. There is a link between insomnia and anxiety. Many antidepressants that are effective for treating anxiety are also given to treat insomnia.
3. Antidepressant medications are safer than other medications used to induce sleep.
4. Antidepressants act immediately, allowing for faster relief from insomnia.

Question 2

A client is taking verapamil for hypertension, Glucotrol for management of type II diabetes, and melatonin for sleep. Which question should the nurse ask about these medications?

1. How is the melatonin helping you with sleep?
2. How long have you been taking the verapamil for blood pressure control?
3. What was the result of your last hemoglobin A1C level?
4. What was your blood pressure before you began taking the verapamil?

djpooyouma · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 2
Rationale 1: Paxil is a selective serotonin reuptake inhibitor (SSRI). It is used to treat anxiety-induced insomnia.
Rationale 2: There is a pathophysiologic link between sleep and anxiety, and many of the drugs used to treat anxiety also are effective for treating insomnia.
Rationale 3: Antidepressants have a lower abuse potential than do other medications used to induce sleep, but that is not the reason this client was prescribed the antidepressant.
Rationale 4: SSRIs can take months for optimum therapeutic benefit to be achieved.
Global Rationale: There is a pathophysiologic link between sleep and anxiety, and many of the drugs used to treat anxiety also are effective for treating insomnia. Paxil is a selective serotonin reuptake inhibitor (SSRI). It is used to treat anxiety-induced insomnia. Antidepressants have a lower abuse potential than do other medications used to induce sleep, but that is not the reason this client was prescribed the antidepressant. SSRIs can take months for optimum therapeutic benefit to be achieved.

Answer to Question 2

Correct Answer: 1
Rationale 1: There is evidence that melatonin helps older adults fall sleep faster and helps insomnia related to disrupted circadian rhythm cycles.
Rationale 2: The length of time verapamil has been taken is not relevant.
Rationale 3: Even though it would be nice to know how well the diabetes has been controlled over the last 23 months, it is not necessary knowledge. Most illnesses cause an untoward increase in blood sugar levels, despite previously controlled levels.
Rationale 4: It would be important to know the control of blood pressure after taking the verapamil.
Global Rationale: There is evidence that melatonin helps older adults fall sleep faster and helps insomnia related to disrupted circadian rhythm cycles. The length of time verapamil has been taken is not relevant. Even though it would be nice to know how well the diabetes has been controlled over the last 23 months, it is not necessary knowledge. Most illnesses cause an untoward increase in blood sugar levels, despite previously controlled levels. It would be important to know the control of blood pressure after taking the verapamil.