When administering zolpidem to an older adult client, which computer documentation indicates that the desired outcome has been achieved?

Exhibits fewer emotional outbursts.

Decreased episodes of incontinence.

Improved ability to concentrate.

Sleeps soundly through the night.

Answer and Explanation

The Correct Answer is D

A. Exhibits fewer emotional outbursts: Zolpidem is a sedative-hypnotic medication primarily used to treat insomnia. A reduction in emotional outbursts is not a direct expected outcome of this medication. While improved sleep might indirectly influence mood, it is not the primary therapeutic goal.

B. Decreased episodes of incontinence: Zolpidem's primary action is on the central nervous system to promote sleep. A decrease in episodes of incontinence is not a direct pharmacological effect of zolpidem.

C. Improved ability to concentrate: Zolpidem is a sedative and can potentially cause daytime drowsiness or cognitive impairment rather than improving concentration. Its intended effect is to induce sleep, which could indirectly benefit concentration if the client's difficulty concentrating was due to sleep deprivation, but it's not a direct outcome of the medication itself.

D. Sleeps soundly through the night: The intended therapeutic effect of zolpidem is to help the client initiate and maintain sleep. Documentation stating that the client sleeps soundly through the night indicates that the medication has achieved its desired outcome.

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Correct Answer is ["B","C","D","F"]

Explanation

A. Ibuprofen: While ibuprofen can affect renal function and has its own risks in diabetes, it does not have a significant or consistent effect on insulin requirements. It is not a primary medication impacting glucose metabolism.

B. Oral contraceptive: Estrogen in oral contraceptives can cause increased insulin resistance, potentially requiring higher doses of insulin to maintain glucose control. Therefore, it can affect the client’s insulin needs.

C. Corticosteroids: Corticosteroids such as prednisone raise blood glucose levels by promoting gluconeogenesis and insulin resistance. Clients taking corticosteroids often require increased insulin dosing.

D. Epinephrine: Epinephrine stimulates glycogen breakdown and raises blood glucose levels as part of the stress response. It can significantly impact blood sugar control and thus influence insulin requirements.

E. St. John's Wort: St. John's Wort can interact with many medications, but its effect on insulin or blood glucose regulation is not strong enough to significantly alter insulin needs. It is more notable for affecting medications through liver enzyme induction.

F. Fluconazole: Fluconazole can inhibit the metabolism of some drugs and may increase insulin sensitivity in certain cases. It can alter glucose control by enhancing insulin action, which may lead to a need for insulin dose adjustments.

A. Obtain a specimen for a urine culture. B. Explain the color change is normal. C. Measure the client's urinary output. D. Encourage an increase in oral intake.

Correct Answer is B

Explanation

A. Obtain a specimen for a urine culture: A urine culture is necessary when infection is suspected, typically indicated by symptoms like burning, urgency, or foul odor. Darker urine alone in a client on carbidopa/levodopa is not an indication for infection testing.

B. Explain the color change is normal: Carbidopa/levodopa can cause harmless discoloration of bodily fluids, including darker urine, sweat, and saliva due to the metabolism and excretion of the medication. This is a well-known and non-threatening side effect that does not require intervention beyond client reassurance.

C. Measure the client's urinary output: Monitoring urinary output is important in cases of suspected dehydration or renal dysfunction, but simply darker urine without changes in volume or symptoms does not justify additional measurement in this scenario.

D. Encourage an increase in oral intake: While adequate hydration is always encouraged, the urine color change reported here is due to the medication itself, not dehydration. Therefore, increasing fluid intake will not reverse or prevent the discoloration.

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When administering zolpidem to an older adult client, which computer documentation indicates that the desired outcome has been achieved?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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