Which assessment finding indicates to the nurse why the patient is having difficulty sleeping at night?

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.

Choice A reason: This is incorrect. The PCA will not give additional pain medication whenever the button is pushed. The PCA is programmed to deliver a specific dose of pain medication at a specific interval. If the button is pushed before the interval is over, the PCA will not release any medication. This is to prevent overdose and side effects.

Choice B reason: This is incorrect. The PCA will not deliver medication through the IV until the pain is all gone. The PCA is designed to provide pain relief, not pain elimination. The PCA has a limit on how much medication it can deliver in a certain period of time. The patient may still have some pain even after using the PCA.

Choice C reason: This is correct. You or a designated family member are the only one who gets to push the PCA button-nobody else may do so. The PCA is intended to give the patient control over their pain management. The patient should push the button when they feel pain, not when someone else thinks they need it. Allowing others to push the button can lead to under- or over-medication, which can be harmful.

Choice D reason: This is incorrect. Wait until the pain becomes severe before pushing the PCA button is not a good instruction. The PCA is more effective when the patient pushes the button before the pain becomes too intense. Waiting too long can make the pain harder to control and require more medication. The patient should use the PCA as needed to keep the pain at a tolerable level..