A female client with mild depression reports to the nurse of recently starting St. John's wo’t. Which information provided by the client requires further instruction?

Sensitivity to the sun can develop.

Hard candy can be used for a dry mouth.

Insomnia may occur while taking the medication.

Another form of contraception is not needed.

Answer and Explanation

The Correct Answer is D

A) Sensitivity to the sun can develop: St. John's wo’t can increase photosensitivity, making the skin more prone to sunburn. Therefore, clients should be advised to use sunscreen and protective clothing when exposed to sunlight.

B) Hard candy can be used for a dry mouth: Dry mouth is a common side effect of St. John's wo’t. Suggesting the use of hard candy can help alleviate the discomfort associated with dry mouth by stimulating saliva production.

C) Insomnia may occur while taking the medication: St. John's wo’t may cause insomnia or exacerbate existing sleep disturbances. Clients should be informed about this potential side effect so they can monitor their sleep patterns and seek appropriate management if needed.

D) Another form of contraception is not needed: This statement requires further instruction. St. John's wo’t can decrease the effectiveness of hormonal contraceptives, including birth control pills, patches, and rings. Therefore, clients using hormonal contraceptives should be advised to use additional or alternative methods of contraception to prevent unintended pregnancy.

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Correct Answer is D

Explanation

A) Take the benzodiazepine at the same time of taking the morphine: This statement is incorrect. Benzodiazepines and morphine are both central nervous system depressants and can potentiate each other’s effects, leading to increased sedation and respiratory depression. Taking them together without proper supervision or dosage adjustment can be dangerous. Therefore, this statement indicates a misunderstanding of the medication regimen.

B) Do not drink grapefruit juice after taking morphine: While grapefruit juice can interact with certain medications by affecting their metabolism, there is no specific interaction between grapefruit juice and morphine that requires avoidance. Therefore, this statement is not directly related to the use of morphine for bone pain.

C) Watch for signs of agitation and record any insomnia: While it is important to monitor for side effects of morphine, such as agitation and insomnia, this statement does not directly relate to the management of constipation, which is a common side effect of opioid analgesics like morphine.

D) Observe bowel movement pattern and take a stool softener: This is the correct answer. Morphine is known to cause constipation as a side effect due to its action on opioid receptors in the gastrointestinal tract. Therefore, monitoring bowel movements and taking a stool softener can help prevent or alleviate constipation associated with morphine use. This statement indicates an understanding of the potential side effects of the medication and the importance of managing them appropriately.

A. Sleeps soundly through the night. B. Exhibits fewer emotional outbursts. C. Improved ability to concentrate. D. Decreased episodes of incontinence,

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.

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A female client with mild depression reports to the nurse of recently starting St. John's wo’t. Which information provided by the client requires further instruction?

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Explanation

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Correct Answer is A

Explanation

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