Nokea
A nursing student is caring for an older adult with arthritis who states she did not sleep well and was 'up all night to use the bathroom.' To help promote sleep, the student plans to discuss re-timing which medication with the primary nurse?
- A. Furosemide (diuretic) 10:00 AM, 10:00 PM
- B. Melatonin 9:00 PM
- C. Acetaminophen 10:00 AM, 10:00 PM
- D. Artificial tears every 8 hours, 8:00 AM, 2:00 PM, 8:00 PM
Correct Answer: A
Rationale: It is best to administer diuretics in the morning or early evening to prevent nocturia. Melatonin promotes sleep and rest. Acetaminophen can relieve arthritis pain and help promote rest. Artificial tears, used for dry eyes, will not affect sleep.
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A nurse observes involuntary muscle jerking in a sleeping patient. What action will the nurse take next?
- A. No action is necessary; this is normal in stage 1 sleep.
- B. Report the neurologic deficit to the health care provider.
- C. Lower the temperature in the patient's room.
- D. Awaken the patient, as this is an indication of night terrors.
Correct Answer: A
Rationale: Involuntary muscle jerking occurs in stage I NREM sleep and is a normal finding. No further actions are needed for this patient.
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 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 is caring for an older adult who is having trouble falling asleep at night. What nursing interventions are appropriate for this patient?
- A. Assess the patient for depression.
- B. Discourage napping during the day.
- C. Decrease fluids during the evening.
- D. Administer diuretics in the morning.
- E. Encourage the patient to engage in some type of physical activity.
- F. Assess medication for side effects of sleep pattern disturbances.
Correct Answer: A,B,C,D,E,F
Rationale: For patients who are having trouble initiating sleep, the nurse should arrange for assessment for depression and treatment, discourage napping, promote activity, and assess medications for sleep disturbance side effects. Limiting fluids and administering diuretics in the morning are appropriate interventions.
After reporting an adult patient's loud snoring and changes in vital signs occurring overnight the patient's health care provider, a nocturnal polysomnography study is prescribed. What teaching will the nurse provide about this test?
- A. This is a blood test, taken in the evening to evaluate leptin and ghrelin.
- B. The patient is monitored overnight to evaluate for sleep apnea.
- C. A patient is evaluated for leg jerking and awakenings during the night.
- D. Adults, rather than children, can be diagnosed with this test.
Correct Answer: B
Rationale: Polysomnography is an overnight sleep study to determine if an individual has sleep apnea and treatment. Leptin and ghrelin are hormones that regulate nutritional intake. Leptin signals the brain to stop eating, whereas ghrelin promotes continued eating. Research suggests that sleep deprivation lowers leptin levels and elevates ghrelin levels, increasing appetite; however, this does not help diagnose sleep apnea. Jerking legs in the early stage of intravenously is expected. Both adults and children can benefit from diagnosis of sleep apnea with this test.