A nurse teaches a nursing student about pharmacologic ...

[HCHenry]

A nurse teaches a nursing student about pharmacologic interventions for the treatment of sleep problems among older adults. Which of the following statements by the student shows understanding of the care of those with sleep disturbances?
 
  A) Behavioral therapies are preferable to the use of drugs.
  B) Benzodiazepines are the drug group likely to have the fewest adverse effects.
  C) L-Tryptophan and melatonin are chemicals the body produces that can be supplemented to improve sleep.
  D) Older adults should not use hypnotics or other pharmacologic aids for sleep.

Question 2

A nurse in a long-term care facility has noticed that many residents of the facility spend a large amount of time in bed yet frequently complain of fatigue and sleep deprivation.
 
  What change in the facility's environment is most conducive with helping residents achieve adequate amounts of restful sleep?
 
  A) Keeping the lights at a consistent, low level throughout the day and night
  B) Allowing residents to awake/sleep according to their own routines
  C) Maintaining the facility at a temperature of 78F to 80F during the night
  D) Checking on each resident every 2 hours during the night to ensure safety

[mcni194]

Answer to Question 1

Ans: A
In general, behavioral therapies are preferable to hypnotics and other drugs for the treatment of sleep disorders. Benzodiazepines are the drug category with the greatest risk of adverse effect, and L-tryptophan is found in foods rather than produced by the body. Even though there are risks, there is still a role for pharmacologic interventions in the short-term treatment of sleep problems and they should not be categorically discounted.

Answer to Question 2

Ans: B
It is important not to schedule the time for awakening clients/residents based on the most efficient use of nursing and dietary time that require clients/residents to adjust their sleep routines accordingly. Lighting should be bright during the day and dark at night in order to foster normal circadian rhythms. A temperature of 78F to 80F during the night is likely too warm to promote restful sleep. Safety concerns are not related to the issue of adequate sleep.