A nurse is caring for a client who has borderline personality disorder (BPD). What should the nurse monitor in the client’s Medication Administration Record?
Medication compliance.
Adverse reactions.
Medication interactions.
Dosage adjustments.
The Correct Answer is A
Choice A rationale:
Medication compliance is crucial in the management of BPD because:
Instability and Impulsivity: Individuals with BPD often struggle with impulsivity and unstable moods, which can lead to inconsistent medication adherence. They may forget to take their medications, take them at the wrong times, or stop taking them altogether when they feel better or worse. This can disrupt the therapeutic effects of the medications and increase the risk of relapse or worsening symptoms.
Multiple Medications: BPD is often treated with a combination of medications, such as mood stabilizers, antidepressants, and antipsychotics. Each medication has its own unique dosing schedule, side effects, and potential for interactions. Monitoring compliance ensures that the client is taking all medications as prescribed, reducing the risk of adverse events and optimizing treatment outcomes.
Mental Health Stigma: Unfortunately, mental health stigma can contribute to medication noncompliance. Individuals with BPD may feel ashamed or embarrassed about their diagnosis, leading them to hide their medication use or avoid taking medications altogether. By openly discussing medication compliance and addressing any concerns, nurses can help reduce stigma and promote adherence.
Therapeutic Relationship: A strong therapeutic relationship between the nurse and client is essential for promoting medication compliance in BPD. Nurses can foster trust and open communication by:
Actively listening to the client's concerns about medications.
Providing clear and concise education about the purpose and benefits of medications.
Collaborating with the client to develop a medication regimen that fits their lifestyle and preferences.
Regularly assessing medication adherence and addressing any barriers to compliance.
Offering support and encouragement to the client throughout the treatment process.
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Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Hemoglobin (Hgb) of 11 g/dL is slightly below the normal range for adult females (12-16 g/dL) but is not considered a critical value.
It may indicate mild anemia, which is common in bulimia nervosa due to factors such as poor nutrition and blood loss from self-induced vomiting. However, it would not typically be the most urgent finding requiring immediate intervention.
Choice B rationale:
Potassium of 2.8 mEq/L is significantly below the normal range (3.5-5.0 mEq/L) and is considered a critical value, indicating severe hypokalemia.
Hypokalemia is a potentially life-threatening electrolyte imbalance that can lead to cardiac arrhythmias, muscle weakness, respiratory failure, and even death.
It is a common complication of bulimia nervosa due to excessive vomiting and/or laxative abuse, which can lead to significant potassium loss.
Therefore, this finding would be the nurse's priority, necessitating immediate intervention to correct the hypokalemia and prevent potentially life-threatening complications.
Choice C rationale:
Serum chloride of 96 mEq/L is slightly below the normal range (98-106 mEq/L) but is not considered a critical value.
It may be associated with hypokalemia, as chloride and potassium are often lost together in conditions like bulimia nervosa.
However, it would not typically be the most urgent finding requiring immediate intervention.
Choice D rationale:
Serum amylase of 240 units/L is elevated above the normal range (30-110 units/L) but is not considered a critical value.
It may indicate inflammation of the pancreas (pancreatitis), which can be a complication of bulimia nervosa due to recurrent vomiting and/or alcohol abuse.
However, it would not typically be the most urgent finding requiring immediate intervention, especially in comparison to severe hypokalemia.
Correct Answer is C
Explanation
A rationale:
Going to another room and reading for 20 minutes when waking up at night is a recommended strategy for managing insomnia. This technique helps to break the cycle of lying in bed awake and worrying, which can worsen insomnia. Reading can be a relaxing activity that can help to promote sleepiness. It's important to choose a book that is not too stimulating and to avoid reading in bright light.
Choice B rationale:
Stopping napping in the afternoon is also a recommended strategy for managing insomnia. Napping can interfere with nighttime sleep by reducing sleep drive. It's best to avoid napping altogether or to limit naps to 30 minutes or less early in the afternoon.
Choice C rationale:
Watching television in the bedroom is not recommended for managing insomnia. The light from the television can suppress the production of melatonin, a hormone that helps to regulate sleep. The noise from the television can also be stimulating and make it difficult to fall asleep. It's best to avoid watching television in the bedroom or to turn off the television at least 30 minutes before bedtime.
Choice D rationale:
Eating the evening meal at least 3 hours before bed is generally a good practice for sleep hygiene. Eating too close to bedtime can lead to indigestion, which can make it difficult to fall asleep. It's best to avoid heavy, fatty, or spicy foods before bed.
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