NURS_6630_Week8_Assignment 2 Assessing and treating patients with sleep/wake disorders

ORDER NOW FOR AN ORIGINAL PAPER!!!NURS_6630_Week8_Assignment 2 Assessing and treating patients with sleep/wake disorders .

Insomnia

31-year-old Male

Decision Point One

Trazodone 50 mg po at bedtime

RESULTS OF DECISION POINT ONE

Patient returns to clinic in 2 weeks
Patient states medication works well but gives him an unpleasant side effect of an erection lasting approximately 15 minutes after waking
Patient states this makes it difficult to get ready for work or go downstairs and have coffee with his girlfriend and daughter in the morning
Patient denies auditory/visual hallucinations and is future oriented

Decision Point Two

Decrease trazodone to 25 mg daily at bedtime

RESULTS OF DECISION POINT TWO

Patient returns to clinic in 2 weeks
Patient states trazodone is very effective for sleep
Patient states sometimes the 25 mg dosage isnâ€™t quite enough to help him sleep through the night
Patient denies auditory/visual hallucinations and is future oriented

ORDER NOW FOR AN ORIGINAL PAPER!!!NURS_6630_Week8_Assignment 2 Assessing and treating patients with sleep/wake disorders .

Decision Point Three

Continue dose. Encourage sleep hygiene. Follow up in 4 weeks

Guidance to Student

Since the patient is already showing a partial response from trazodone, it may not be prudent to switch therapy. A thorough sleep hygiene analysis should always be performed prior to initiation of pharmacotherapy as well as at reassessments. If you find the patient isn’t practicing proper sleep hygiene, you may continue the dose and encourage sleep hygiene. If the patient is practicing good sleep hygiene, you may consider discontinuing trazodone and initiating hydroxyzine. Although there are some negative side effects associated with hydroxyzine such as Xerostomia and Xerophthalmia, it is still a safer medication to prescribe than ramelteon.