Which client likely faces a risk for the nursing diagnosis of Disturbed Sleep Pattern: Difficulty Remaining Asleep?
A client whose opioid analgesics result in central nervous system depression.
A client whose physical therapy has been scheduled for 4:30 p.m.
A client who requires blood glucose checks 4 times daily.
A client who receives IV antibiotics every 3 hours.
The Correct Answer is D
Choice A rationale
Opioid analgesics, while causing central nervous system depression and potentially leading to drowsiness and difficulty falling asleep, are less likely to directly cause difficulty *remaining* asleep. Their primary effect on sleep is usually at the initiation stage due to their sedative properties.
Choice B rationale
Physical therapy scheduled for 4: p.m. might cause some fatigue, potentially aiding sleep onset. However, unless it causes significant pain or discomfort later in the night, it's unlikely to be a primary factor in difficulty remaining asleep.
Choice C rationale
Frequent blood glucose checks, while potentially disruptive, are typically brief interventions. Unless the client experiences significant fluctuations in blood sugar levels that cause nocturnal symptoms like sweating or palpitations, these checks are less likely to be the main cause of difficulty remaining asleep. Normal fasting blood glucose ranges from 70 to 100 mg/dL.
Choice D rationale
Intravenous antibiotics administered every 3 hours necessitate frequent awakenings throughout the night to maintain therapeutic drug levels. These repeated interruptions to the sleep cycle directly interfere with the ability to remain asleep, fragmenting sleep patterns and preventing the client from achieving restorative sleep.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While reporting communicable diseases is a public health responsibility, it is typically mandated by law and health regulations, not specifically a requirement that nurses *always* report to the Board of Nursing in Texas. Reporting protocols usually involve health departments.
Choice B rationale
Parents declining treatment for a child can raise ethical and legal concerns, potentially involving child protective services or the legal system, but it is not always a direct reporting requirement to the Texas Board of Nursing unless it involves professional misconduct by a nurse.
Choice C rationale
A patient's decision to leave against medical advice is a matter of patient autonomy. While nurses document this and ensure the patient understands the risks, it is not typically a mandatory reporting situation to the Texas Board of Nursing unless there are specific concerns about the nurse's conduct related to the discharge.
Choice D rationale
Abuse of older adults by another nurse directly involves the professional conduct and potential harm caused by a licensed nurse. The Texas Board of Nursing is responsible for regulating nursing practice and ensuring patient safety, making it mandatory for nurses to report such instances of misconduct by a colleague.
Correct Answer is D
Explanation
Choice A rationale
The amount of stage 4 (deep, slow-wave) sleep actually decreases as individuals age. Older adults tend to have less deep sleep and more fragmented sleep patterns with increased awakenings.
Choice B rationale
Circadian rhythms, the body's internal clock regulating sleep-wake cycles, tend to become less prominent or more easily disrupted as clients age. This can lead to changes in sleep timing, such as earlier bedtimes and wake times.
Choice C rationale
Older clients typically take longer to fall asleep (increased sleep latency) compared to younger individuals due to various physiological and environmental factors.
Choice D rationale
Total sleep time generally decreases with age. Older adults often require and obtain less sleep per night compared to younger adults. This is a normal physiological change associated with aging.
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