A patient's nursing diagnosis is Insomnia. The desired outcome ...

[Mr.Thesaxman]

A patient's nursing diagnosis is Insomnia. The desired outcome is: Patient will sleep for a minimum of 5 hours nightly by October 31.
 
  On November 1, a review of the sleep data shows the patient sleeps an average of 4 hours nightly and takes a 2-hour afternoon nap. Which evaluation should be documented?
 
  a. Consistently demonstrated
  b. Often demonstrated
  c. Sometimes demonstrated
  d. Never demonstrated

Question 2

A patient with major depression has lost 20 pounds in one month has chronic low self-esteem and a plan for suicide. The patient has taken an antidepressant medication for 1 week. Which nursing intervention is most directly related to this outcome:
 
  Patient will refrain from gestures and attempts to harm self?
 
  a. Implement suicide precautions.
  b. Frequently offer high-calorie snacks and fluids.
  c. Assist the patient to identify three personal strengths.
  d. Observe patient for therapeutic effects of antidepressant medication.

[Cheesycrackers]

Answer to Question 1

ANS: D
Although the patient is sleeping 6 hours daily, the total is not in one uninterrupted session at night. Therefore the outcome must be evaluated as never demonstrated.

Answer to Question 2

ANS: A
Implementing suicide precautions is the only option related to patient safety. The other options, related to nutrition, self-esteem, and medication therapy, are important but are not priorities.