The nurse admits a patient with narcolepsy to the ...

[Engineer]

The nurse admits a patient with narcolepsy to the psychiatric-mental health unit. Which statements best describe the medication choices for this disorder? Select all that apply.
 
  1. Sodium oxybate is given at night to consolidate sleep.
  2. Traditional stimulants are given to increase wakefulness.
  3. Antidepressants are used because they are known to suppress REM sleep.
  4. Diphenhydramine is often the first line drug because of its safety profile.
  5. Antipsychotics may be prescribed to reduce cataplexy.

Question 2

The care plan for a newly admitted patient includes orders for stimulant medication and two scheduled naps per day. The nurse knows these are standard treatments for which sleep-wake disorder?
 
  1. Narcolepsy
  2. Central sleep apnea
  3. Hypersomnolence disorder
  4. Circadian rhythm disorder

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Answer to Question 1

Answer: 1, 2, 3
Explanation: Treatment of narcolepsy is largely pharmacological. Sodium oxybate is given at night to consolidate sleep, although it is not the first line drug to treat this disorder. When treating narcolepsy, traditional stimulants are given to increase wakefulness and antidepressants are used because they are known to suppress REM sleep. Diphenhydramine and antipsychotics are not used to treat narcolepsy.

Answer to Question 2

Answer: 3
Explanation: Hypersomnolence disorder is excessive daytime sleepiness in the presence of at least 7 hours of nighttime sleep and is a diagnosis of exclusion. It is treated with stimulants and naps. Narcolepsy is excessive daytime sleepiness that often results in loss of muscle tone as REM sleep intrudes on wakefulness and is treated pharmacologically, often with antidepressants to suppress REM sleep. Central sleep apnea occurs with 5 or more apneic periods in an hour with loss of ventilatory effort. It may be treated with CPAP or by discontinuing medications that contribute to decreased respiratory effort. Circadian rhythm disorders are a group of sleep problems resulting from variations in light, physical activity, work schedules and the effects of aging. These are often treated with melatonin or changes to sleep hygiene.

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