A patient tells the nurse she takes Advil PM (ibuprofen plus ...

[Shelles]

A patient tells the nurse she takes Advil PM (ibuprofen plus diphenhydramine) every night for sleep along with the use of CPAP for sleep apnea. She states that lately she is feeling hung over in the morning. What is the best response by the nu
 
  1. Are you using the CPAP regularly the way it was ordered?
  2. That medication is not recommended for people with sleep apnea.
  3. That's a safe over-the-counter medication. What other meds do you take?
  4. I will let the physician know so that she can order a new sleep study for you.

Question 2

A patient admitted to the psychiatric-mental health unit tells the nurse she is having trouble sleeping because of all the commotion in the hospital. The patient adds that she does not normally have problems with sleep.
 
  What is the best statement by the nurse?
  1. You should go on a brisk walk right before bed.
  2. You should turn on the TV to mask the noises on the unit.
  3. I'll talk to the doctor and ask him to order you a sleeping pill.
  4. I will get you some ear plugs so that you won't hear as much noise at night.

[nmyers]

Answer to Question 1

Answer: 2
Explanation: Diphenhydramine is contraindicated for patients with sleep apnea because it can increase severity of apnea and decrease the likelihood that the patient will awake with the apneic event. A new sleep study might be indicated at some point, but not as a first response. Diphenhydramine is not safe for this patient, and questioning the patient's adherence to treatment should not be the first response for this scenario.

Answer to Question 2

Answer: 4
Explanation: Because the patient does not have a history of insomnia, the noise of the unit is probably contributing to her sleeplessness. Addressing the noise with ear plugs is a reasonable first step. Medication is not the first option. Turning on a TV to mask other noise is not a good sleep hygiene practice. Exercise should be completed at least 3 hours before bed to prevent wakefulness.