Lillian fell when she was returning from the bathroom after the suppository. The

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 WNL. Lillian had a small bruise on her rib cage but no fracture. The physician gave the nurse the following orders over the phone.

Acetaminophen 325 mg po every 4 hours as needed for pain
Zolpidem 5 mg po at bedtime for sleep

How would the nurse assess Lillian

Explanation / Answer

1. The nurse can assess the pain by observing the behavior of the patient. If the patient can herself give the needed data its best. Otherwise if the patient is unable to talk, the nurse can ask questions and ask the patient to nod her head. The body language also shows signs of being in pain. The time period the nurse needs to assess the patient is every 4 hours.

2. Zolpidem is a sedative. The mechanism of action is that it is an agonist of the GABA A ? 1 subunit. Since it increases the affinity of the receptor for GABA, it causes sleep. The onset is about half an hour and duration is for the night. Sometimes the patient can still feel sleepy in the morning. This depends on the dose. The safety considerations are:

3. Heparin is an anticoagulant which prevents pulmonary emboli and deep vein thromboses. This molecule binds to the antithrombin III inhibitor. This activates the inhibitor. It then activates thrombin and other proteins which take part in the clotting process. Action takes place in 30 minutes. Safety considerations are:

4. Warfarin is also an anticoagulant. It is a vitamin K antagonist. It inhibits vitamin K epoxide reductase. They reduce the amount of K. The duration is within 24 hours and can act till 5 days.

SAfety considerations:

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