Which is the safest sleep aid for the elderly patient with insomnia?

Choice A reason: This is an incorrect choice because sleep-wake pattern is not the most important assessment to determine if a patient is receiving sufficient sleep. Sleep-wake pattern is the cycle of sleeping and waking that follows a circadian rhythm. However, it is not a reliable indicator of sleep quality or quantity, as different people may have different sleep-wake patterns that suit their needs and preferences.

Choice B reason: This is an incorrect choice because hours of sleep each night is not the most important assessment to determine if a patient is receiving sufficient sleep. Hours of sleep each night is the duration of sleep that a person gets in a 24-hour period. However, it is not a reliable indicator of sleep quality or quantity, as different people may have different sleep needs and requirements that vary according to age, lifestyle, health, and other factors.

Choice C reason: This is the correct choice because whether the patient feels rested is the most important assessment to determine if a patient is receiving sufficient sleep. Feeling rested is the subjective perception of the patient about their sleep quality and quantity. It is a reliable indicator of sleep sufficiency, as it reflects the patient's satisfaction and well-being after sleeping.

Choice D reason: This is an incorrect choice because frequency of nocturia is not the most important assessment to determine if a patient is receiving sufficient sleep. Frequency of nocturia is the number of times that a person has to urinate at night. However, it is not a reliable indicator of sleep quality or quantity, as it may be influenced by other factors such as fluid intake, medication, or medical conditions.

Choice A reason: This is an incorrect choice because a patient with chronic viral conjunctivitis would not benefit from the use of lubricant eye ointment. Conjunctivitis is an inflammation of the conjunctiva, which is the thin membrane that covers the white part of the eye and the inner surface of the eyelid. Viral conjunctivitis is caused by a virus, such as adenovirus or herpes simplex virus, and it can cause redness, itching, burning, tearing, or discharge in the eye. Lubricant eye ointment is a thick, greasy substance that can moisturize and protect the eye, but it can also trap the virus and worsen the infection. The patient with viral conjunctivitis should use artificial tears or saline drops instead, and avoid sharing towels, cosmetics, or eye drops with others.

Choice B reason: This is the correct choice because a stroke patient whose right eye does not close fully would benefit from the use of lubricant eye ointment. A stroke is a sudden interruption of blood flow to the brain, which can cause damage to the brain cells and affect various functions, such as movement, sensation, speech, or vision. A stroke patient whose right eye does not close fully may have facial paralysis or weakness on the right side of the face, which can impair the ability to blink or close the eye. This can cause dryness, irritation, or injury to the eye, especially at night. Lubricant eye ointment can help to keep the eye moist and prevent corneal ulcers or infections. The patient may also need to wear an eye patch or tape the eye shut during sleep.

Choice C reason: This is an incorrect choice because a patient with an eye infection after swimming in a pond would not benefit from the use of lubricant eye ointment. An eye infection is an inflammation or infection of the eye or its structures, such as the cornea, the iris, or the eyelid. Swimming in a pond can expose the eye to various microorganisms, such as bacteria, fungi, or parasites, that can cause eye infections. Some examples are Acanthamoeba keratitis, which is a rare but serious infection of the cornea caused by a parasite, or Pseudomonas aeruginosa, which is a common cause of bacterial conjunctivitis. Lubricant eye ointment is not effective against these microorganisms, and it can also interfere with the penetration of antibiotic or antifungal eye drops. The patient with an eye infection after swimming in a pond should seek medical attention and use the prescribed eye drops as directed.

Choice D reason: This is an incorrect choice because a patient who has extended-wear contact lenses in place would not benefit from the use of lubricant eye ointment. Extended-wear contact lenses are soft lenses that can be worn continuously for up to 30 days and nights, without the need to remove them for cleaning or disinfection. However, extended-wear contact lenses can increase the risk of eye infections, such as bacterial or fungal keratitis, which can cause severe pain, redness, blurred vision, or sensitivity to light. Lubricant eye ointment is not compatible with contact lenses, and it can damage the lens material or cause deposits or cloudiness on the lens. The patient who has extended-wear contact lenses in place should follow the instructions of the eye care provider and remove the lenses immediately if any signs of infection or irritation occur.