Based on a client’s serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement?

Choice A reason:

Insomnia is a known side effect of St. John’s wort. While it can be bothersome, it does not typically require further instruction beyond standard advice on managing insomnia. Patients should be advised to take the medication earlier in the day to minimize sleep disturbances.

Choice B reason:

St. John’s wort can interact with hormonal contraceptives, reducing their effectiveness and increasing the risk of unintended pregnancy. This interaction occurs because St. John’s wort induces the enzymes that metabolize contraceptive hormones, leading to lower levels of these hormones in the body. Therefore, it is crucial to instruct the client to use an additional form of contraception to prevent pregnancy.

Choice C reason:

Sensitivity to the sun, or photosensitivity, is a documented side effect of St. John’s wort. Patients should be advised to use sunscreen and wear protective clothing when exposed to sunlight. While this side effect requires caution, it does not necessitate further instruction beyond these preventive measures.

Choice D reason:

Using hard candy to alleviate dry mouth is a common and effective strategy. St. John’s wort can cause dry mouth, and sucking on sugar-free hard candy can help stimulate saliva production. This advice is appropriate and does not require further instruction.

Choice A reason:

Decreased episodes of incontinence are not a relevant outcome of administering zolpidem. Zolpidem is a sedative-hypnotic medication primarily used to treat insomnia by enhancing the activity of GABA, an inhibitory neurotransmitter. It does not affect urinary function or bladder control. Incontinence may be caused by other factors such as aging, prostate problems, or urinary tract infections, but it is not influenced by zolpidem.

Choice B reason:

Improved ability to concentrate is not a pertinent outcome of administering zolpidem. This medication does not enhance cognitive function or attention span. In fact, zolpidem may impair memory and cause daytime drowsiness or confusion in some patients. Its primary function is to induce sleep, not to improve concentration.

Choice C reason:

Exhibiting fewer emotional outbursts is not a significant outcome of administering zolpidem. This medication does not affect mood or behavior. In some cases, zolpidem may cause paradoxical reactions such as agitation, aggression, or hallucinations, especially in older adults. Therefore, it is not used to manage emotional outbursts.

Choice D reason:

Sleeps soundly through the night is the desired outcome of administering zolpidem. This medication is specifically designed to treat sleep problems, particularly difficulty falling asleep or staying asleep. By enhancing the activity of GABA, zolpidem helps induce and maintain sleep, which is the primary goal when prescribing this medication to patients with insomnia.