What interventions can the nurse apply to help an older adult client who is having trouble sleeping while in the hospital? (Select all that apply.)
a. Changing the client's sheets each night before sleep
b. Decreasing the level of light surrounding the client's bed
c. Attempting to keep the client awake dur-ing the daytime
d. Keeping staff conversations as quiet as possible
e. Administering sleeping pills at night
f. Administering pain medication before bedtime
g. Asking the client if he or she would like to pray
B, C, D, F
Sleep disorders are common in hospitalized clients, especially older adults. The primary contri-buting factors for clients who have trouble sleeping are pain, chronic disease, environmental noise and lighting, and staff conversations. To help clients get adequate rest, the nurse should try to keep the client awake in the daytime to ensure that she or he is tired at night. Dimming the lights and keeping conversations quiet and farther from clients' rooms will help eliminate some of the environmental factors, and administering pain medication at bedtime will enhance the client's ability to fall asleep without pain.
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Aids to memory and mental function that an older adult might use include
a. List making and environmental cues b. A wide variation of daily experiences to trigger memory c. Attempting to meet new people to keep social skills intact d. Changing routine to avoid getting into repetitive patterns
A patient who has suffered a hemorrhagic stroke is placed on a protocol of 60 mg nimodipine (calcium channel blocker) every 4 hours. The patient's pulse is 82 prior to the administration of the prescribed dose. The nurse should:
1. give the full dose as prescribed, without further assessment. 2. omit the dose, recording the pulse rate as the rationale. 3. delay the dose until the pulse is below 60. 4. give half of the prescribed dose (30 mg).
The nurse provides a pain medication to a patient. The patient did not ask for the medication. What should the nurse do?
a. Nothing. b. Document the effectiveness of the medication. c. Provide the time of the pain medication during the next shift report. d. Report the error.
A pt with MS is prescribed oral fingolimod (Gilenya). Which key point must the nurse teach the pt about the drug?
a. "you must be carefully monitored for allergic or anaphylactic reaction because the drug tends to build up in the body" b. "we need to teach you how to monitor your pulse rate because this drug can cause a slow heart rate" c. "this drug will decrease the frequency of clinical relapses that you will have with MS" d. "it will improve your ability to walk but also puts you at increased risk for seizure activity"