An older patient is being prescribed medication to help with sleep. What should the nurse include in this patient's plan of care?
1. Diazepam is the best benzodiazepine to use for sleep.
2. A benzodiazepine should only be used for 2 weeks.
3. Lorazepam should be avoided for sleep in the older patient.
4. A higher dose of an antidepressant medication is needed for sleep.
2
Rationale: It is important to avoid using the benzodiazepines with longer half-lives such as diazepam since this drug is associated with a high abuse potential, daytime sedation and falls, and memory impairment.
Rationale 2: Benzodiazepine therapy is recommended for short-term use not to exceed 2 weeks.
Rationale 3: Shorter-acting benzodiazepines such as lorazepam are suggested to be the better choice for older adults because these drugs have the best effects and fewer safety concerns.
Rationale 4: Lower doses of tricyclic antidepressants are needed for sleep disorders than are needed to treat depression.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 4. List the risks and benefits of pharmacological and nonpharmacological interventions for sleep disturbance.
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