A nurse is caring for a client who has an anxiety disorder and reports ongoing difficulty sleeping at night. Which of the following recommendations should the nurse make?

Choice A reason: This statement is incorrect. Buspirone is not known to cause dependence, which is one of the reasons it is often preferred for the treatment of generalized anxiety disorder. Unlike benzodiazepines, which can lead to dependence and withdrawal symptoms, buspirone does not have these effects, making it a safer long-term option for managing anxiety.

Choice B reason: There is no specific dietary restriction regarding the consumption of leafy green vegetables when taking buspirone. This statement might confuse the client unnecessarily. Dietary interactions are more commonly associated with certain other medications, such as MAO inhibitors, which require patients to avoid tyramine-rich foods to prevent hypertensive crises. However, this does not apply to buspirone.

Choice C reason: This statement is accurate and important for the client to understand. Buspirone typically takes several weeks to achieve its full therapeutic effect. Clients should be advised to continue taking the medication as prescribed and not to expect immediate relief of anxiety symptoms. This information helps set realistic expectations and encourages adherence to the treatment plan.

Choice D reason: This statement is incorrect and could lead to improper medication administration. If a dose of buspirone is missed, it should not be doubled up with the next dose. Instead, clients should take the missed dose as soon as they remember unless it is almost time for their next scheduled dose. Doubling up on doses can increase the risk of side effects and is not a safe practice.

Choice A reason: Drinking alcohol, such as red wine, before bed is not recommended for improving sleep. While alcohol may initially make a person feel drowsy, it can disrupt the sleep cycle, leading to poor sleep quality and frequent awakenings during the night. It is better to avoid alcohol close to bedtime to promote better sleep hygiene.

Choice B reason: Limiting caffeine intake to one or two servings during daytime hours is a beneficial recommendation for improving sleep. Caffeine is a stimulant that can interfere with the ability to fall asleep and stay asleep. By reducing caffeine consumption and avoiding it in the late afternoon and evening, individuals can enhance their chances of achieving restful sleep.

Choice C reason: Exercising 1 hour before bedtime is not advisable as vigorous physical activity close to bedtime can be stimulating and may make it harder to fall asleep. It is generally recommended to finish exercise at least a few hours before bedtime to allow the body to wind down and prepare for sleep.

Choice D reason: Staying in bed for 1 hour before getting up if unable to sleep can lead to frustration and anxiety about not being able to sleep. It is more effective to get out of bed and engage in a quiet, relaxing activity until feeling sleepy, then return to bed. This approach helps associate the bed with sleep rather than wakefulness.