Once a week, staff members from all the disciplines caring for the trauma patients get together to discuss their progress. Which term best describes this patient care action?

Choice A reason: This is the correct choice because the apical pulse is the most accurate measurement of the heart rate and rhythm. Digoxin is a cardiac medication that affects the heart rate and can cause arrhythmias. Therefore, the nurse should use the apical pulse to monitor the patient's response to the medication.

Choice B reason: This is an incorrect choice because the carotid pulse is not the best site to measure the heart rate before administering digoxin. The carotid pulse is located in the neck and can be affected by external factors such as pressure or movement. The carotid pulse is also not recommended for routine use because it can stimulate the vagus nerve and lower the heart rate.

Choice C reason: This is an incorrect choice because the radial pulse is not the best site to measure the heart rate before administering digoxin. The radial pulse is located in the wrist and can be affected by peripheral factors such as circulation or temperature. The radial pulse can also be inaccurate or irregular if the patient has an arrhythmia.

Choice D reason: This is an incorrect choice because the brachial pulse is not the best site to measure the heart rate before administering digoxin. The brachial pulse is located in the upper arm and can be affected by arm position or blood pressure. The brachial pulse is also not as reliable as the apical pulse for detecting changes in the heart rate and rhythm.

Choice A reason: This is an incorrect choice because the patient follows an organic, low-carbohydrate diet is not an assessment finding that indicates to the nurse why the patient is having difficulty sleeping at night. A low-carbohydrate diet may have some benefits for weight loss, blood sugar control, and cardiovascular health, but it does not have a direct impact on the sleep quality or quantity of the patient.

Choice B reason: This is the correct choice because the patient now works in Alaska with extended daylight hours is an assessment finding that indicates to the nurse why the patient is having difficulty sleeping at night. Extended daylight hours can disrupt the circadian rhythm, which is the natural cycle of sleeping and waking that follows a 24-hour pattern. The circadian rhythm is influenced by the exposure to light and dark, and it regulates the production of melatonin, a hormone that promotes sleep. When the daylight hours are longer, the melatonin levels may be lower, and the patient may have trouble falling asleep or staying asleep.

Choice C reason: This is an incorrect choice because the patient’s job includes many hours of hard labor each day is not an assessment finding that indicates to the nurse why the patient is having difficulty sleeping at night. Hard labor may have some effects on the physical and mental health of the patient, but it does not necessarily cause insomnia or poor sleep. In fact, hard labor may increase the need for sleep and rest, and the patient may sleep better after a long day of work.

Choice D reason: This is an incorrect choice because the patient enjoys doing crossword puzzles and reading is not an assessment finding that indicates to the nurse why the patient is having difficulty sleeping at night. Crossword puzzles and reading are hobbies that may stimulate the brain and enhance the cognitive function of the patient, but they do not have a negative effect on the sleep quality or quantity of the patient. However, the nurse should advise the patient to avoid doing these activities close to bedtime, especially if they involve bright screens or lights, as they may interfere with the melatonin production and the sleep onset.