week8assign2Ham, Cdecision treeinsomnia (1)

Document Content and Description Below

INSOMNIA CAROLYN HAM NURS6630 DR. DE CARO 7/24/2021 INTRODUCTION National Sleep Foundation states that most healthy adults should receive 7-8 hours of sleep per night. But experts say... if you feel drowsy during the day, even during boring activities, you have not had enough sleep. Having a tough time getting to sleep at night is quite common, Studies show that half of all Americans report having trouble sleeping occasionally, and more than 1 in 5 suffer from chronic insomnia. (Mccormack,2011). There is primary insomnia, a person who has difficulty with sleep that is not caused by some psychological or physical disorder, and secondary insomnia, a person who has difficulty sleeping due to a medical condition or mental health. Insomnia is a symptom that may result from anxiety, depression, sleep habits, a chronic illness or taking certain chronic medications, pain or a substance abuse issue. In order to treat or help to overcome the sleeplessness' you must first figure out what type of insomnia you are suffering from or you must identify the underlying cause. In the case study provided, the client has lost a loved one, and I feel this has added to his poor sleep habits, even though he stated he had sleeping habits problems before his fiancé passed away. The purpose of this paper is to treat the symptom of insomnia for the client listed and treat with the minimal side effects and do no harm to the client. Decision 1 I chose Trazadone 50mg-100 mg daily at night. Trazadone is an antidepressant medication used to treat cognitive health problems including insomnia. The medicine works by balancing the neurotransmitters in the brain, used to help people fall asleep because it can cause drowsiness as a side effect. Trazadone works by increasing the availability of serotonin in the CNS. It is a SSRI, leaving serotonin available in the CNS for longer periods of time and addresses issues with depression. Therefore, Trazadone has found to be a greater sleep aid than an antidepressant medication (Drugs.com,2018). Trazadone is the best choice of the three meds. I didn’t choose Zolpidem because it is a habit-forming medication and would never be the first step in treatment for insomnia. It is a sedative also called a hypnotic with several serious cardiac side effects. This is a medication that would be tried after others have failed, like a last resort. Hydroxyzine also has a sedative property that is why sometimes it is used for insomnia. I didn’t choose hydroxyzine because of the warning's signals of the increased risk of Q-T interval and increased blood pressure which may cause arrhythmia and cardiac arrest. (WebMD) I expect after the client returns to the clinic; he will report that his sleep has been improved with minimal side effects. Decision 2 Client returned to the office and reported that medication works well for sleep, but it gives him one unpleasant side effect, a prolonged erection that interferes with his activities in the morning. Client denies auditory and visual hallucinations, he said the Trazadone is working very well the question now is to re- evaluate and decide if to switch the medications, because of the side effects or continue with the same medication. I chose to offer some patient teaching about the side effect he was having and continue the dose. Patients need to know that the side effect is common and will subside in a couple weeks. I made the decision to offer some patient teaching with the client to explain this a common side effect and it will leave soon and continue the dose. This decision is all about compliance because if patient has any uncomfortable side effects, he may stop taking his medication. ETHICAL CONSIDERATIONS First consideration is to establish a strong therapeutic rapport with the client to ensure that if any issues arise client will be more likely to share and report those to the provider. Ensuring the client .................................................................................continued................................................................ [Show More]

Last updated: 2 years ago

Preview 1 out of 7 pages