A client with narcolepsy receives a new prescription for methylphenidate. Prior to administration of the medication, the nurse should review the medical record for which condition?

A) Sleeps soundly through the night: Zolpidem is a sedative-hypnotic medication commonly prescribed for the short-term treatment of insomnia in older adults. The desired outcome of administering zolpidem is improved sleep quality, including the ability to sleep soundly through the night. Documenting that the client sleeps soundly through the night indicates that the medication has achieved its intended effect of promoting sleep.

B) Exhibits fewer emotional outbursts: While zolpidem may indirectly contribute to emotional stability by improving sleep quality, it is not primarily indicated for reducing emotional outbursts. Therefore, this documentation does not specifically reflect the desired outcome of zolpidem administration.

C) Improved ability to concentrate: Zolpidem’s primary effect is on sleep induction rather than concentration. While improved sleep may indirectly enhance concentration in some cases, this documentation does not directly relate to the intended outcome of zolpidem therapy.

D) Decreased episodes of incontinence: Zolpidem is not indicated for the treatment of urinary incontinence, so documenting a decrease in episodes of incontinence would not reflect the desired outcome of zolpidem administration.

Therefore, the most appropriate documentation indicating that the desired outcome has been achieved when administering zolpidem to an older client is that the client “sleeps soundly through the night.” This reflects the medication’s primary purpose of improving sleep quality and duration.

1. Begin cardioversion to stabilize heart rhythm: Cardioversion is not the appropriate intervention for digoxin toxicity. Digoxin toxicity can cause arrhythmias, but the initial action should be to assess and manage the underlying cause, rather than immediately proceeding to cardioversion.

B) Give digoxin by another route to slow absorption: Slowing the absorption of digoxin is not the appropriate action for treating digoxin toxicity. Instead, the focus should be on managing the existing toxicity and preventing further absorption by withholding additional doses.

C) Administer potassium to stabilize the heart rate: While potassium may be indicated as part of the treatment for digoxin toxicity, particularly if hypokalemia is contributing to the toxicity, it is not the initial action. The priority is to assess the client’s acid-base and electrolyte values to identify any abnormalities contributing to the toxicity.

D) Check acid-base and electrolyte values: This is the correct action. Digoxin toxicity can be exacerbated by electrolyte imbalances, particularly hypokalemia, hypercalcemia, and hypomagnesemia. Therefore, assessing the client’s acid-base and electrolyte values is essential to identify and correct any abnormalities contributing to the toxicity. Once identified, appropriate interventions can be implemented to manage the toxicity and stabilize the client’s condition.