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Difficulty: HardLifestyle Choices

A 72-year-old resident in an assisted living facility reports persistent fatigue and difficulty maintaining sleep throughout the night. While discussing daily routines, the resident mentions consuming a glass of fortified wine right before bed to "settle the nerves" and eating a heavy, culturally specific meal at 9:00 PM with visiting family members. Which action by the practical nurse (PN) is the most appropriate?

  1. A
    Create and implement an individualized behavioral sleep modification plan that outlines strict cutoff times for food and fluid intake.
  2. B
    Direct the resident to stop eating the late-night family meals and consume only the facility's scheduled dinner at 5:00 PM.
  3. Document the reported routines, reinforce that late-night alcohol can fragment sleep, and gather more details about the family's evening meal schedule.Answer
  4. D
    Ask the resident, 'Why do you choose to drink wine for your nerves when it is clearly making your insomnia worse?'

Answer

Document the reported routines, reinforce that late-night alcohol can fragment sleep, and gather more details about the family's evening meal schedule.
The correct action perfectly aligns with the practical nurse's scope of practice, which involves comprehensive data collection and reinforcing known health information. While alcohol initially acts as a central nervous system depressant and may help a person fall asleep, it frequently causes sleep fragmentation and early morning awakenings. Furthermore, gathering more information about the cultural meal schedule allows the healthcare team to plan collaborative, patient-centered care without disregarding the resident's cultural traditions.

Step-by-Step Solution

1
Analyze the client's reported lifestyle choices.
The client engages in poor sleep hygiene practices by consuming a heavy meal and alcohol right before bed.
Identifying the specific lifestyle factors contributing to the insomnia is necessary for targeted intervention.
2
Determine the practical nurse (PN) scope of practice in this scenario.
The PN can collect further data, document findings, and reinforce standard health education, but cannot independently create a new care plan.
Adhering to the PN scope of practice ensures safe and legal delegation of care.
3
Evaluate the cultural and psychosocial aspects of the resident's routine.
The late-night meal has cultural and familial significance, meaning any intervention must be respectful and collaborative.
Ignoring cultural needs or using non-therapeutic communication damages the nurse-client relationship and decreases compliance.
4
Select the option that synthesizes scope of practice, lifestyle education, and cultural sensitivity.
The best action is to gather more information, document it for the RN, and reinforce the known physiological effects of alcohol on sleep.
This provides safe, holistic, and scope-appropriate care.

Key Concept

Reinforcing healthy lifestyle choices and sleep hygiene while maintaining scope of practice and cultural sensitivity.
Estimated Time:1m 30s
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Topics

Lifestyle Choices

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