A client is being assessed for complaints of difficulty getting ...

[s.tung]

A client is being assessed for complaints of difficulty getting to and staying asleep, chronic fatigue, and difficulty staying awake during daytime hours.
 
  A sleep study has been ordered. Which medication should the nurse teach the client to avoid prior to the sleep study?
  1. Fosinopril (Monopril), 10 mg p.o. q.d., an ACE inhibitor
  2. Calan SR, (verapamil) 120 mg p.o. q.d., a calcium channel blocker
  3. Folic acid, 1 mg p.o.
  4. Buspirone (BuSpar), 10 mg p.o. b.i.d., a nonbenzodiazepine anxiolytic

Question 2

A client with anxiety and insomnia has been taking alprazolam (Xanax) for five days. What is the priority for the nurse to assess in this client?
 
  1. Stopping the use of birth control pills
  2. Thoughts of suicide
  3. Taking the medication with grapefruit juice
  4. Drowsiness after taking the medication

[xoxo123]

Answer to Question 1

Correct Answer: 4
Rationale 1: Drowsiness is generally not a side effect of ACE inhibitors, so taking this medication should not have an effect on the results of the sleep study.
Rationale 2: Drowsiness is not a side effect of Calan SR. There are no indications that this medication would interfere with results of a sleep study.
Rationale 3: Folic acid would not have an effect on the results of the sleep study.
Rationale 4: Drowsiness is a common side effect of BuSpar. This could affect the results of a sleep study.
Global Rationale: Drowsiness is a common side effect of BuSpar. This could affect the results of a sleep study. Drowsiness is generally not a side effect of ACE inhibitors or Calan SR so taking these medications should not have an effect on the results of the sleep study. Folic acid would not have an effect on the results of the sleep study.

Answer to Question 2

Correct Answer: 2
Rationale 1: Xanax is a category D drug, and should not be taken during pregnancy. However, the client should not stop taking birth control pills because of the risk of pregnancy.
Rationale 2: Examples of such behaviors that should be reported to the health care provider immediately include aggressiveness, hallucinations, suicidal thinking, and unusual extroversion or depersonalization. This could indicate a serious underlying psychiatric or medical condition that requires further assessment.
Rationale 3: Grapefruit or grapefruit juice taken while on Xanax might inhibit the metabolism of Xanax. The client should have been instructed to avoid grapefruit and grapefruit juice before starting the medication.
Rationale 4: Drowsiness is a common side effect of benzodiazepines that would not suddenly occur after taking the medication for 5 days.
Global Rationale: Examples of such behaviors that should be reported to the health care provider immediately include aggressiveness, hallucinations, suicidal thinking, and unusual extroversion or depersonalization. This could indicate a serious underlying psychiatric or medical condition that requires further assessment. Xanax is a category D drug, and should not be taken during pregnancy. However, the client should not stop taking birth control pills because of the risk of pregnancy. Grapefruit or grapefruit juice taken while on Xanax might inhibit the metabolism of Xanax. The client should have been instructed to avoid grapefruit and grapefruit juice before starting the medication. Drowsiness is a common side effect of benzodiazepines that would not suddenly occur after taking the medication for 5 days.

[s.tung]

Gracias!

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TYSM