When providing patient teaching to an older adult patient and her ...

[Caiter2013]

When providing patient teaching to an older adult patient and her daughter, the nurse cautions them about avoiding which over-the-counter medication often used by patients with sleep-wake disorders?
 
  1. Zolpidem
  2. Ramelteon
  3. Trazodone
  4. Diphenhydramine

Question 2

The nurse suggests the use of meditation before bedtime for a patient diagnosed with a sleep-wake disorder. Which type of cognitive-behavioral therapy is the nurse suggesting?
 
  1. Sleep hygiene
  2. Cognitive therapy
  3. Relaxation training
  4. Stimulus control therapy

[joneynes]

Answer to Question 1

Answer: 4
Explanation: Diphenhydramine is an antihistamine that is thought by many to be benign because it is available over-the-counter. However, it can be dangerous, especially in older adults, because it can be sedating for up to 18 hours and cause orthostatic hypotension. Zolpidem has a low adverse effect profile and is not available over-the-counter. Ramelteon should be used cautiously in patients with depression with suicidal ideations and is available by prescription only. Trazodone is commonly used in low doses for sleep but can also cause orthostatic hypotension. Trazodone is also available only by prescription. The nurse should carefully monitor any older adult taking medication for a sleep-wake disorder.

Answer to Question 2

Answer: 3
Explanation: Meditation and imagery training are aimed at reducing tension and promoting relaxation at bedtime. Sleep hygiene refers to health practices and behaviors that promote sleep. Cognitive-behavioral therapy is directed at changing misconceptions about insomnia and keeping people from stressing about it during the day. Stimulus control therapy involves a set of specific instructions to the patient about bedtime and controlling the environment.