The nurse is preparing to apply the client’s scheduled fentanyl transdermal patch. The nurse notes the previously applied patch is intact on the client’s upper back and the client reports no pain. Which action should the nurse take?

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.

A) Provide information on increasing medication dosage if ketoacidosis occurs: While it is important for clients with diabetes to understand the signs and symptoms of diabetic ketoacidosis (DKA) and how to respond, increasing insulin dosage on their own without healthcare provider guidance could be dangerous. Adjusting insulin dosage should always be done under the direction of a healthcare provider.

B) Teach the client self-injection skills for daily subcutaneous administration: Insulin glargine is a long-acting insulin used for basal (background) insulin coverage in clients with diabetes. Teaching the client how to self-administer insulin injections is essential for effective management of diabetes, especially when using long-acting insulin formulations like insulin glargine. Proper injection technique, site rotation, and storage of insulin are important aspects of this teaching.

C) Demonstrate how to select dose based on before meal blood sugar readings: Insulin glargine is typically administered once daily at the same time each day and is not adjusted based on before meal blood sugar readings. Instead, it provides a steady level of insulin over 24 hours to help control blood sugar levels between meals and overnight.

D) Explain to the family how to inject this medication for severe hypoglycemia: Insulin glargine is not used for the treatment of severe hypoglycemia. Instead, it is a long-acting insulin used to maintain basal insulin levels in clients with diabetes. Severe hypoglycemia is treated with fast-acting glucose sources such as oral glucose tablets, gel, or glucagon injections, and the family should be educated on these treatments instead.