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A nurse is providing discharge teaching for patients regarding their medications. For which patients would the nurse recommend actions to promote sleep?
- A. Patient taking iron supplements for anemia
- B. Patient with Parkinson's disease who is taking dopamine
- C. Older adult taking diuretics for congestive heart failure
- D. Child taking antibiotics for an ear infection
- E. Patient taking antidepressants
- F. Patient taking low-dose aspirin prophylactically
Correct Answer: B,C,E
Rationale: Drugs that decrease REM sleep include barbiturates, amphetamines, and antidepressants. Diuretics, antiparkinsonian drugs, some antidepressants and antihypertensives, steroids, decongestants, caffeine, and asthma medications are seen as additional common causes of sleep problems.
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A patient experiencing menopause tells the nurse at the medical clinic that she would like to try a CAH hormonal sleep aid like her friend uses. What information can the nurse give the patient?
- A. Melatonin, an over-the-counter hormonal sleep aid, has varied effectiveness.
- B. Lavender is a hormonal scented sleep aid.
- C. Lorazepam, a naturally occurring benzodiazepine, is recommended for sleep.
- D. Valerian is a natural hormonal sleep aid.
Correct Answer: A
Rationale: Melatonin, used as a complementary or alternate to traditional pharmacologic agents, is a hormone thought to regulate the sleep-wake cycle. Valerian is an herb; lavender is a plant used for aromatherapy and relaxation. Benzodiazepines are pharmacologic medications used to decrease anxiety and promote sleep and relaxation.
A nurse recommends that a patient with a sleep disorder keep a sleep diary. Which data will the nurse ask the patient to document?
- A. Daily mental activities
- B. Daily physical activities
- C. Morning and evening body temperature
- D. Daily measurement of fluid intake and output
- E. Presence of anxiety or worries affecting sleep
- F. Morning and evening blood pressure readings
Correct Answer: A,B,E
Rationale: A sleep diary includes mental and physical activities performed during the day and the presence of any anxiety or worries the patient may be experiencing that affect sleep. A record of fluid intake and output, body temperature, and blood pressure is typically kept in the graphic record.
At an annual health and wellness visit, the parent of an adolescent reports a teacher's concerns that their child is sleepy at school during class time. Which information will the nurse share with the parent and child?
- A. Adolescents typically need 8 to 10 hours of sleep each night.
- B. Demands on the adolescent's time causes them to sleep longer hours.
- C. Insufficient sleep can lead to daytime sleepiness.
- D. Adolescents require reduced sleep in the teen years.
- E. The adolescent could benefit from a sleep study for insomnia.
Correct Answer: A,C
Rationale: Adolescents require 8 to 10 hours of sleep nightly; however, demands on their time cut into the needed sleep. Insufficient sleep can lead to daytime sleepiness.
A nurse in a rehabilitation facility develops a plan to help promote patients' sleep. What interventions will the nurse include in the plan?
- A. Maintain a consistent bedtime and time to awaken.
- B. Drink two or three glasses of water at bedtime.
- C. Have a large snack at bedtime.
- D. Take a sedative-hypnotic every night at bedtime.
Correct Answer: A
Rationale: Keeping a consistent bedtime and awakening schedule, even when up late, helps promote sleep. Drinking two or three glasses of water at bedtime will probably cause the patient to awaken during the night to void. A large snack may be uncomfortable right before bedtime; instead, a small protein and carbohydrate snack is recommended. Taking a sedative-hypnotic every night disturbs REM and NREM sleep, and sedatives also lose their effectiveness quickly.
A nurse on a postpartum unit is teaching new parents about newborn safety and sleep patterns. Which comment from a parent indicates further teaching is required?
- A. I can expect my newborn to sleep an average of 16 to 24 hours a day.
- B. Eye movements or groans during my baby's sleep is an emergency.
- C. It is essential that I place my infant on their back to sleep.
- D. I will not place pillows or blankets in the crib to prevent suffocation.
Correct Answer: B
Rationale: Eye movements, groaning, grimacing, and moving are normal activities at this age; no emergency exists. Newborns sleep an average of 16 to 24 hours a day. Infants should be placed on their backs for the first year to prevent SIDS. Parents should be cautioned about placing pillows, crib bumpers, quilts, stuffed animals, and other items in the crib as they pose a suffocation risk.