A client who had orthopedic surgery 3 days ago complains of difficulty sleeping. Which initial intervention is best for the practical nurse (PN) to implement?
Administer a PRN prescription for pain.
Reposition the client and provide a back rub
Offer the client a prescribed sleep medication
Provide a cup of hot chocolate at bedtime
The Correct Answer is B
A. Administer a PRN prescription for pain: While postoperative pain can interfere with sleep, pain medication should be given only after assessing and addressing comfort measures. Nonpharmacologic interventions should be attempted first unless the client reports significant pain.
B. Reposition the client and provide a back rub: Repositioning promotes comfort and improves circulation, while a back rub helps the client relax and may relieve mild muscle tension. These nonpharmacologic measures are safe, promote rest, and are appropriate as an initial nursing intervention for sleep difficulty.
C. Offer the client a prescribed sleep medication: Sedative or hypnotic medications may be necessary for persistent insomnia, but they should not be the first intervention. The nurse should attempt comfort measures before administering pharmacologic sleep aids.
D. Provide a cup of hot chocolate at bedtime: Hot chocolate contains caffeine, which can stimulate the nervous system and interfere with sleep. Offering warm milk or herbal tea would be a better bedtime option, but comfort measures should be prioritized first.
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Related Questions
Correct Answer is D
Explanation
A. Explain that the pharmacy often substitutes generic equivalents for more expensive brands: While true, this explanation alone does not ensure patient safety or confirm that the correct medication was dispensed. Verification is necessary before administration.
B. Explain that the healthcare provider probably prescribed a different medication while he is hospitalized: Assuming a change in prescription without verification could lead to medication errors and compromise safety. Confirmation from the pharmacy or provider is required.
C. Tell the client that he is probably confused since being hospitalized tends to disorient clients: Dismissing the client’s concern undermines trust and could result in a medication error. Patient concerns should always be taken seriously.
D. Tell the client that the PN will verify that the dispensed medication is the valid prescription: The safest response respects the client’s observation and ensures accurate verification. This action prioritizes patient safety, confirms the correct medication, and maintains trust.
Correct Answer is B
Explanation
A. Order supplies for a dressing change: Obtaining supplies is part of routine postoperative care but is not the first priority. Before any intervention, the PN must ensure the client’s vital functions, airway, breathing, and circulation, are stable.
B. Monitor cardiorespiratory status: Following abdominal surgery, the greatest immediate risk is respiratory compromise due to anesthesia, pain, or immobility. Monitoring the client’s breathing and cardiac function is the first priority to detect hypoxia, respiratory depression, or hemodynamic instability early.
C. Assess the client’s pain level: Pain assessment is important for comfort and to encourage deep breathing and mobility. However, cardiorespiratory monitoring takes precedence, as it ensures life-sustaining stability before addressing discomfort.
D. Provide an incentive spirometer: Promoting lung expansion is beneficial in preventing postoperative atelectasis, but the PN must first confirm adequate respiratory status before instructing or assisting with incentive spirometry.
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