A client whose spouse recently died is having difficulty falling ...

[audragclark]

A client whose spouse recently died is having difficulty falling asleep and does not want to take any prescription medications to induce sleep. Which response by the nurse is the most appropriate?
 
  Standard Text: Select all that apply.
  1. Walking 23 miles or engaging in some other exercise every morning can enhance sleep.
  2. There are alternative methods to treat insomnia, such as yoga, meditation, and massage therapy.
  3. Eating a large meal at bedtime will help induce sleep.
  4. Avoid caffeinated beverages, nicotine, and alcohol immediately prior to bedtime.
  5. Count sheep after lying down in order to enhance sleep.

Question 2

A client who recently experienced the loss of a spouse asks the nurse if there are any over-the-counter herbs or nonprescription medications that can be used to improve insomnia. Which response by the nurse is the most appropriate?
 
  Standard Text: Select all that apply.
  1. Ginger root is commonly taken to improve sleep.
  2. Ginkgo is an herb commonly taken to improve sleep.
  3. Diphenhydramine (Benadryl) and doxylamine are over-the-counter meds sometimes taken to produce drowsiness.
  4. Valerian and melatonin are herbs commonly taken to improve sleep.
  5. Kava is an herb taken to improve sleep.

[Pamela.irrgang@yahoo.com]

Answer to Question 1

Correct Answer: 1,2,4
Rationale 1: Exercise therapy (except just prior to sleeping), nutrition therapy, and deep breathing are alternative treatments for insomnia.
Rationale 2: Acupuncture, aromatherapy, yoga, prayer, massage, meditation, biofeedback therapy, hypnosis, guided imagery, and music therapy are alternative treatments for anxiety and insomnia.
Rationale 3: Eating a large meal prior to bedtime is a secondary cause of insomnia.
Rationale 4: Amphetamines, cocaine, caffeinated beverages, corticosteroids, sympathomimetics, antidepressants, alcohol use, nicotine, and tobacco use are secondary causes of insomnia.
Rationale 5: There is no evidence that counting sheep at bedtime helps to induce sleep.
Global Rationale: Exercise therapy (except just prior to sleeping), nutrition therapy, and deep breathing are alternative treatments for insomnia. Acupuncture, aromatherapy, yoga, prayer, massage, meditation, biofeedback therapy, hypnosis, guided imagery, and music therapy are alternative treatments for anxiety and insomnia. Amphetamines, cocaine, caffeinated beverages, corticosteroids, sympathomimetics, antidepressants, alcohol use, nicotine, and tobacco use are secondary causes of insomnia. Eating a large meal prior to bedtime is a secondary cause of insomnia. There is no evidence that counting sheep at bedtime helps to induce sleep.

Answer to Question 2

Correct Answer: 3,4
Rationale 1: Ginger root is not used to improve sleep.
Rationale 2: Ginkgo is not used to improve sleep.
Rationale 3: Diphenhydramine and doxylamine are two antihistamines frequently used to produce drowsiness.
Rationale 4: An herbal product with demonstrated efficacy in promoting relaxation is valerian root. Supplemental melatonin, 0.53.0 mg at bedtime, is alleged to decrease the time required to fall asleep and to produce a deep and restful sleep.
Rationale 5: High doses of kava can damage the liver and should not be used unless recommended by a health care provider.
Global Rationale: Diphenhydramine and doxylamine are two antihistamines frequently used to produce drowsiness. An herbal product with demonstrated efficacy in promoting relaxation is valerian root. Supplemental melatonin, 0.53.0 mg at bedtime, is alleged to decrease the time required to fall asleep and to produce a deep and restful sleep. Ginger root and ginkgo are not used to improve sleep. High doses of kava can damage the liver and should not be used unless recommended by a health care provider.

[audragclark]

Thank you!

[Pamela.irrgang@yahoo.com]

Always glad to help...