Question

Lillian fell when she was returning from the bathroom after the suppository. The nurse found her sitting on the floor complaining of pain on the left side of her rib cage. The nurse called for help and assisted Lillian back to bed. She notified the physician and completed the necessary reports. The physician ordered a follow-up chest X-ray that came back within normal limits. Lillian had a small bruise on her rib cage but no fracture. The physician gave the nurse the following orders over the phone.

Acetaminophen (Tylenol) Zolpidem (Ambien) Alprazolam (Xanax)

Acetaminophen (Tylenol) 325 mg po every 4 hours as needed for pain

Zolpidem (Ambien) 5 mg po at bedtime for sleep

Alprazolam (Xanax)0.5 mg po as needed for anxiety

How would the nurse assess Lillian’s pain, and when would the nurse assess for pain when giving the acetaminophen?

How does zolpidem work? Be sure to include drug category, mechanism of action, onset and duration of action, and safety considerations.

What are the factors that contributed to Miss Lillian’s fall?

Answer 1

Nurse can assess Lillian's pain when she becomes restless. Moreover, the drug acetaminophen or Tylenol is prescribed for every 4 hours to subside the pain. This is because the injury though not serious but is causing a severe pain. Therefore, nurse has to check for every 4 hours and should give the patient the acetaminophen.

Zolpidem is class of drugs called sedative or hypnotics. It acts very quickly by activating the sleep center of brain and relaxes from stress. Therefore, it is prescribed to take just before going to bed. This drug is mainly prescribed to treat insomnia or sleeplessness. As severe pain may cause disturbance in Lillian's sleep, zolpidem is prescribed so that she can have good sleep and enough rest. The drug makes the patient to have enough sleep of 7 to 8 hours. The drug should be given for short periods and not more than 2 weeks. After the short period side effects like, nervousness, light headedness, nausea, vomitting, sweating and restlessness may be observed for one or two nights and then become normal.

Stress, anxiety, sleeplessness or insomnia are the factors contributed to Miss Lillian's fall.