During a home visit, the nurse assesses a client with Alzheimer's Di’ease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take?
Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's sa’ety.
Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's in’omnia.
Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed.
Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started.
The Correct Answer is D
A) Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's sa’ety: Withholding the medication without consulting the healthcare provider may not be appropriate, especially if the client is experiencing improvements in cognitive function. The insomnia may be a temporary side effect that could resolve with continued use or adjustment of the dosage.
B) Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's in’omnia: Increasing the dosage of rivastigmine to manage insomnia may not be the most appropriate action. It's es’ential to assess the client further and explore other interventions before considering a dosage adjustment.
C) Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed: Rivastigmine is not typically used to promote sleep. It is a cholinesterase inhibitor used to treat cognitive symptoms associated with Alzheimer's di’ease. Therefore, advising a change in medication solely based on the client's in’omnia is not appropriate.
D) Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started: Rivastigmine and other cholinesterase inhibitors may cause insomnia, especially when therapy is initiated. Educating the caregiver about this common side effect helps manage expectations and provides reassurance that the insomnia may improve over time as the client's bo’y adjusts to the medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["100"]
Explanation
Since the client weighs 90 kg, let’s first convert their weight to pounds to determine the appropriate cefazolin dosage:
Conversion factor: 1 kg = 2.205 pounds
Client weight (pounds) = 90 kg x 2.205 pounds/kg = 198.45 pounds (rounded to two decimals)
Now, comparing the client’s weight (198.45 pounds) to the weight threshold (265.5 pounds):
Client weight is less than the threshold (198.45 pounds < 265.5 pounds).
Therefore, the appropriate dosage is:
Cefazolin 2 grams/100 mL 0.9% normal saline over 1 hour.
The pump rate is determined by the total volume of the IV fluid and the infusion time.
We are not given the specific bag size, but typically these come in 100 mL or 500 mL volumes.
Assuming a 100 mL bag (which aligns with the concentration provided):
Total volume of IV bag: 100 mL
Infusion time: 1 hour
Calculation:
Pump rate (mL/hr) = Total volume (mL) / Infusion time (hr)
Pump rate (mL/hr) = 100 mL / 1 hour = 100 mL/hr
Therefore, the nurse should program the pump to deliver 100 mL/hr.
Correct Answer is A
Explanation
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.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.