An older client who is hospitalized has been having difficulty sleeping since admission and is prescribed a low dose of zolpidem (Ambien). Why is the nurse most concerned about administering this medication?
1. It is not a natural option like melatonin.
2. It is associated with daytime hangover and sleepiness.
3. The client is documented as being on fall precautions.
4. The client takes diphenhydramine (Benadryl) for allergies.
3. The client is documented as being on fall precautions.
Explanation: 1. Melatonin is a hormone that is naturally produced by the pineal gland in the human. Melatonin is sold in pharmacies and health food stores and has been effective in improving sleep in some people.
2. With any sleep-inducing medication, daytime sleepiness is a potential. This can be reduced or eliminated by taking the drug earlier in the evening.
3. Ambien is not recommended for use at all in older adults due to risks such as delirium, falls, and fractures. This drug does not work well for this age group.
4. Zolpidem should not be used with diphenhydramine (Benadryl). Diphenhydramine is an antihistamine and is not recommended as a medication for sleep because of anticholinergic side effects and the potential to adversely affect respiratory function.
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