Anxiolytic and Hypnotic Agents; Chapter 20

"This type of medication is typically prescribed to treat excess anxiety that interferes with daily activities."

A hospitalized client asks the nurse why the health care provider prescribed an anxiolytic medication. What is the nurse's best response?

Whether the client is experiencing drug intoxication or withdrawal

A male client is admitted to the emergency department via ambulance. He is attempting to pull out his IV line, exhibiting symptoms of agitation, and thrashing about. The physician orders a benzodiazepine-type sedative. What information is needed prior to administration of the drug?

melatonin

A male client tells the nurse that he has been taking an herbal supplement to aid with insomnia. What herbal supplement is the client taking?

nausea

A nurse has been taught to observe for adverse reactions whenever administering a medication. One non-nervous system reaction after giving a sedative is:

Induces sleep

A nurse is caring for a patient who is prescribed flurazepam. Which is an effect of flurazepam?

Abnormal anxiety is prolonged and impairs normal function

How should the nurse explain the major difference between normal and abnormal anxiety?

paradoxical reaction

The client has been taking a sleep medication for the last 6 months. The client informs the primary care provider that she sleeps great now and wants to discontinue the drug. The provider informs the client that this is not a good idea. What is the best rationale for the providers advice?

Barbiturates can cause paradoxical excitement

The client is experiencing pain. The nurse questions the health care provider's order to administer barbiturates to this client for what reason?

Increased sedative effect

The client suffers from GERD and diverticulosis and has been admitted to a medical floor. The admitting physician orders cimetadine and a sedative to calm the client. What should the nurse be concerned about?

Monitor for increased signs of confusion or forgetfulness.

The daughter of an older adult client asks the nurse if her father should be aware of any special precautions while taking lorazepam (Ativan). What is the nurse's best response?

Blood pressure

The nurse is caring for a client who is receiving an intravenous barbiturate. What assessment should the nurse prioritize?

Increased risk for CNS depression

A patient admitted to the health care facility for alcohol withdrawal has been prescribed an antianxiety medication. Why should the nurse suggest the patient stop consuming alcohol while therapy is ongoing?

Falls

Clients taking benzodiazepines, especially older adult clients, are at high risk for which effect?

barbiturates

A nurse is caring for a patient whose physician has ordered a benzodiazepine sedative-hypnotic. The nurse knows that most of these drugs are used with caution in patients with which disorders?

liver diseases

A nurse is caring for a patient whose physician has ordered a benzodiazepine sedative-hypnotic. The nurse knows that most of these drugs are used with caution in patients with which disorders?

Have resuscitative equipment ready.

A nurse is caring for an elderly patient undergoing antianxiety treatment. The patient is to be administered antianxiety drugs parenterally. What precautions should be taken by the nurse?

Have the client void

A nurse is preparing to administer an anxiolytic to a client. What would be most appropriate for the nurse to do before administering the drug?

The infant may experience withdrawal symptoms during the postnatal period.

If a pregnant client has taken a benzodiazepine during pregnancy, what would be the biggest concern?

1 to 5 minutes

If diazepam is administered intravenously, when will its onset of action be observed?

decreased cardiac workload

In addition to relieving agitation and anxiety, what is a rationale for using benzodiazepines in the treatment of a critically ill client?

tapering the dose of drug over a prolonged period of time

In order to minimize the chances of withdrawal symptoms, the nurse knows that the client prescribed a benzodiazepine taken daily will likely be advised to take which precaution?

difficulty falling asleep at night

A nurse has noted that a newly admitted client has been taking ramelteon for the past several weeks. The nurse is justified in suspecting that this client was experiencing what problem prior to starting this drug?

anxiety

A client is prescribed midazolam in combination with an opioid in the preoperative phase of a laparoscopic cholecystectomy. What does the administration of midazolam assist in minimizing?

bradycardia

A client is receiving a barbiturate intravenously. The nurse would monitor the client for:

2pm

A client received a parenteral benzodiazepine at 11 AM. The nurse would expect to allow the client out of bed at which time?

Lorazepam 2 mg PO

A client who has claustrophobia is scheduled for a magnetic resonance imaging for the investigation of an abdominal mass. The nurse should anticipate what pre-medication order?

increasing the effects of the neurotransmitter GABA

A client who is experiencing acute alcohol withdrawal is being treated with intravenous lorazepam (Ativan). This drug achieves a therapeutic effect by:

buspirone

A client with a high-pressure job temporarily requires an anxiolytic that has no sedative properties. What medication is most likely to meet this client's needs?

"It will not produce sedation like benzodiazepines."

A client's medication regimen for treatment of anxiety has been changed from a benzodiazepine to buspirone (BuSpar). The client asks the nurse what makes this medication safer than the benzodiazepine the client has taken. What is the nurse's best response?

Diazepam (valium)

A group of nursing students answers correctly if they identify which medication as the prototype benzodiazepine?

respiratory disturbances and partial airway obstruction

A 28-year-old patient is to receive a dose of lorazepam intravenously for sedation during a procedure. The nursing priority would be to assess for:

eszopiclone

A 45-year-old male client tells the nurse that he has not slept well for the past 2 weeks. Which drug might the physician prescribe for this client?

"Older adults metabolize the drug more slowly, and half-lives are longer than in younger adults."

A 70-year-old male client asks why he is receiving a lower dose of zaleplon than his son. As part of the nurse's teaching plan, which explanation will the nurse give this client?

a dose adjustment should be made if these symptoms persist

A 70-year-old patient has just started taking lorazepam 10 days ago for anxiety issues related the death of her husband. She is staying with her daughter for a couple of weeks. The patient's daughter has noticed that her mother is having difficulty walking and seems to be confused at times and calls the clinic to report this to the nurse. The nurse will inform the daughter that:

Development of mood disorders

A child diagnosed with night terrors is prescribed a benzodiazepine agent. What increased risk should the child be monitored for?

risk for injury

A client appears very drowsy at bedtime and is difficult to arouse. The client is receiving halcion 0.25 mg PO at bedtime. Based on these findings, what would be the best nursing diagnosis for this client?

Melatonin

A client has been admitted to the surgical floor and is scheduled for an elective minor procedure. During the health history, the client informs the nurse of difficulty sleeping until a few weeks ago when a hormone was recommended by a neighbor and started. To what hormone is this client referring?

Administer the medication as prescribed

A client is experiencing acute anxiety and the nurse has received an order for diazepam 4 mg PO STAT. What is the nurse's best action?

"Be sure not to stop the drug abruptly."

A client is prescribed an anxiolytic agent. What would be most important for the nurse to include in the teaching?

Hypnotic drugs induce drowsiness or sleep. Sedative drugs assist with sleeping. Sedative drugs aid in the healing process by assistance with sleep.

A nurse is preparing to call a prescriber about a client who would like to sleep through the night. The nurse is clarifying with the client the need of a medication to fall asleep, which would be hypnotic, or a medication to relax them like a sedative. What are the differences between sedatives and hypnotics? Select all that apply.

nausea

A nurse knows that when elderly clients take a sedative or hypnotic, they are at increased risk for oversedation. When they become very confused and demonstrate marked excitement, this is known as which type of reaction?

Client is diagnosed with hepatitis C

A nurse obtains a health history from a client who has been prescribed temazepam (Restoril). Which finding would require immediate follow-up by the nurse?

Hepatic impairment Renal impairment Mental health problems Habitual alcohol use

A nurse should be cautious administering sedatives and hypnotics to which clients? (Select all that apply.)

Perform back rubs

A patient admitted to the health care facility for insomnia related to stress is prescribed a sedative. What intervention should the nurse perform to promote the effects of the sedative?

Provide respiratory assistance

A patient undergoing treatment with barbiturates is showing symptoms of barbiturate toxicity. Which intervention should the nurse perform?

avoid driving until he is aware of the adverse effects

A truck driver has been diagnosed with a generalized anxiety disorder (GAD) and lorazepam has been prescribed. The client asked the nurse how this medication will affect his job. The nurse would advise him how?

theophylline

An increased dosage of a prescribed benzodiazepine may be necessary if the client's current regimen includes what medication?

falls risk assessment

An older adult client is diagnosed with generalized anxiety disorder. The use of benzodiazepines in this client population creates a specific need for which intervention?

confusion

An older adult client is prescribed a sedative for the treatment of insomnia. The nurse would suspect that the client is experiencing an adverse reaction to the drug based on assessment of which of the following?

Alcohol withdrawal Seizures Panic attacks

Anxiolytic drugs can be used in the management of which conditions? (Select all that apply.)

False

Barbiturates are considered the sedative and hypnotic drugs of choice.

paradoxical excitement

One week ago, a 74-year-old was started on a benzodiazapine for the treatment of an anxiety disorder. The client comes into the clinic for a follow-up visit and states feeling nervous, is having trouble sleeping, and feels hyperactive. What does the nurse understand may be occurring as a result of this medication?

"Are you currently taking any medications?"

The nurse is assessing a breastfed infant at a well-child visit and determines the child is lethargic and losing weight. Which assessment question should the nurse prioritize? Select all that apply.

Depression of the cerebral cortex

The nurse is providing health education to a client who has been prescribed a barbiturate. The nurse should describe what mechanism of action?

Urinary retention Nausea Nightmares Headache

The nurse is reviewing signs and symptoms of benzodiazepine withdrawal with a client who has taken diazepam daily for several years. The nurse should describe which possible effects of benzodiazepine withdrawal? Select all that apply.

Comatose client

The nurse should not administer sedatives or hypnotic drugs to which client?

The adverse effects of benzodiazepines can persist for several days after stopping the drug

Three days after discontinuing diazepam with medical guidance, an older adult continues to demonstrate impaired memory and confusion. The nurse should consider what possible explanation for the client's current status?

Eszopiclone (Lunesta) Zolpidem (Ambien) Zaleplon (Sonata)

What are examples of nonbenzodiazepine-type hypnotic and sedative drugs? (Select all that apply.)

Status epilepticus Insomnia Preoperative sedation

What are sedatives and hypnotics used to treat? (Select all that apply.)

chronic pain

What aspect of a client's health is most likely to cause insomnia?

antihistamines

What classification of over-the-counter (OTC) medications is often used by clients as treatment for insomnia?

the importance of taking the drug immediately before going to bed

What information should the nurse provide to a client prescribed eszopiclone?

Diazepam

What is the prototype for the classification of drugs referred to as benzodiazepines?

Insomnia

When describing the uses for sedatives and hypnotics, which would the nursing instructor identify as the primary use?

dependence

When providing health education for a client, the nurse should cite what significant risk associated with the adverse effects of benzodiazepines?

Having the client walk to the bathroom

Which action by the new nurse would alert the charge nurse that more education is needed for the new nurse, after administering an anxiolytic to a client?

buspirone

Which agent has no sedative, anticonvulsant, or muscle relaxant properties but does reduce the signs and symptoms of anxiety?

Buspirone (BuSpar)

Which drug used to treat anxiety would be appropriate for a client who is a school teacher and is concerned about feeling sedated at work?

Do not drive or operate heavy machinery while taking the medication. Do not drink alcoholic beverages 2 hours before or within 8 hours after taking the drug.

Which information should be included in the teaching plan of a client who is taking a sedative for a diagnosis of insomnia? Select all that apply.

severe insomnia for the past several nights

Which of the client's current signs and symptoms should cause the nurse to suspect that the client is experiencing lorazepam withdrawal?