Question

Scenario:

Ms. A. A. is a 24 y/o female admitted with complaints of palpitations and shortness of breath. Her most recently vital signs are 100/70, HR 120, RR 22, SpO2 @ 98% on room air. She states she has not been able to sleep for the last five days and appears restless and teary eyed. EKG shows sinus tachycardia and all labs return unremarkable. She denies any past medical history besides issues with sleeping and states she is taking zolpidem 5 mg once daily at bedtime. Despite taking this medication, she has not been able to sleep or stay asleep.

1. What is zolpidem? Include indication, class, mechanism of action, side effects, adverse effects, patient teaching, and nursing considerations.
2. What do you think is the concern here? What other assessment questions would you ask to support your choice? How would you assess the severity of the issue?
3. Identify the various levels of this issue. Explain what can occur at each level and what are the most important nursing considerations and interventions.

When you return to the room, you notice Ms. A. A. sitting in the corner of the room with her hands above her head while she rocks back and forth and repeats “I just want to sleep. I feel so tired but so restless. Why is this happening to me?”

4. What level do you think Ms. A. A. is currently in? What are your initial priority interventions at this time?

Ms. A. A. begins to cry again and asks if the doctor can prescribe something to help her with her feelings of impending doom and worry.

5. What pharmacological treatments are appropriate for this situation? List at least two medications. Include indication, class, mechanism of action, side effects, adverse effects, patient teaching, and nursing considerations.

Ms. A. A. begins to stabilize after administration of medication. Her vital signs show BP 105/78, HR 98, RR 20, Sp02 99% on room air. She begins to dose off and is able to fall asleep. The next morning, Ms. A. A. apologizes for her behavior. She states, “I’m sorry, that was very embarrassing of me to panic like that.”

6. What is an appropriate response to this statement? At this time, what other questions can you ask?

Ms. A. A. begins to reveal that she recently lost her father and worries she will lose her boyfriend too. She states they get into fights often because he tells her to stop worrying but she doesn’t know how to.

7. What would you suggest to Ms. A. A.?
8. List two nursing diagnoses applicable to Ms. A. A.
9. What are some interventions to decrease anxiety? List at least five and provide rationales as appropriate.
10. What are some interventions to promote sleep? List at least five and provide rationales as appropriate.

                                                                                                                

Answer 1

Zolpidem is a Sedative used for treatment of insomnia

Indication- Short Term Treatment Of Insomnia

Class- Sedatives/Hypnotics

Side Effects - Dizziness,Drowsiness, myalgia, visual hallucination, anxiety etc.

Nursing Indications-

Call your doctor immediately if you see any of the following side effects occur while taking zolpidem

• Chest pain
• confusion about identity, place, and time
• fast, irregular, pounding, or racing heartbeat or pulse
• feeling sad or empty
• fever
• general feeling of discomfort or illness
• irritability
• loss of interest or pleasure
• shakiness and unsteady walk
• Change or loss of consciousness
• difficult or troubled breathing
• irregular, fast or slow, or shallow breathing
• pale or blue lips, fingernails, or skin

The Concern Here out Is Besides Taking Medication She is Not able to Sleep and having Increased Heart Rate and Respiratory Rate..

Other Question I would Ask her is Is She Having

Trouble Concentrating, Chest pain ,Memory loss ,Irratability ??

As HOMEWORKLIB Rules I Need To Solve only 1 question with maximum 4 Subparts as It Is Not Mentioned what All To Answer..