Ch. 20 Anxiolytic and Hypnotic Agents

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

"Be sure not to stop the drug abruptly."

The nurse is caring for a client who has been prescribed oxazepam. What statement by the client would suggest an increased risk of CNS depression to the nurse?

"I take an over-the-counter antihistamine each day for my allergies."

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?

"It will not produce sedation like benzodiazepines."

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

2pm

A client informs the nurse that he plans on discontinuing the prescribed lorazepam (Ativan) he has been taking for the past four months. What is the nurse's best action in response to this client's statement?

Advise the client to contact his healthcare provider about tapering off the medication.

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

Diazepam ( valium)

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?

Having the client walk to the bathroom

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

Hepatic impairment Renal impairment Mental health problems Habitual alcohol use

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?

Increased risk for CNS depression

The nurse is reviewing the medication chart of an 82-year-old man who has recently moved to a long-term care facility. The record reveals that the man takes 1 to 2 mg of lorazepam bid prn. The nurse should recognize what consequence of this resident's drug regimen?

Increased risk for falls

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?

Increased sedative effect

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

The infant may experience withdrawal symptoms during the postnatal period.

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?

avoid driving until he is aware of the adverse effects.

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

bradycardia

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

buspirone

A 39-year-old patient who is having trouble sleeping is beginning drug treatment with zaleplon (Sonata). The nurse will be sure to ask if the patient is taking:

cimetidine (Zantac).

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

nausea

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:

respiratory disturbances and partial airway obstruction.

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?

Melatonin

An agent classified as a hypnotic is used primarily for preventing the feelings of tension or fear.

False

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

Induces sleep

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

Lorazepam 2 mg PO

A female client is prescribed a benzodiazepine for anxiety. She asks the nurse if she can stop the drug when she feels better. What is the nurse's best response?

"Benzodiazepines may cause physiologic dependence, and withdrawal symptoms will occur if the drug is stopped abruptly."

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?

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

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

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

A client asks, "How long before sleep should I take ramelteon?" Which time frame will the nurse give this client as part of client teaching?

45 minutes

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?

Administer the medication as prescribed

What exerts its anxiolytic effects by potentiating the effects of gamma-aminobutyric acid (GABA)? (Select all that apply.)

Alprazolam (Xanax) Chlordiazepoxide (Librium) Lorazepam (Ativan)

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

Blood pressure

A client reports constant nervousness, worry, and tension. These signs are indicative of which disorder?

Anxiety

The nurse obtains the following vital signs on a client: BP 160/85, P 90, RR 24. The client is recently divorced and reports taking alprazolam (Xanax) for the past seven weeks but stopped the medication yesterday. What is the nurse's first action?

Ask the client about experiencing increased anxiety, difficulty concentrating, or tremors.

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?

Buspirone (BuSpar)

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

Comatose client

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?

Confusion

The client is scheduled for surgery. The nurse administers diazepam (Valium) preoperatively for what purpose?

Decreased anxiety

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

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

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

Falls

After reviewing the various drugs that are classified as barbiturates, a student demonstrates understanding when identifying which as the prototype?

Phenobarbital

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

Provide respiratory assistance

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?

Risk for injury

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

Triazolam (Halcion) Temazepam (Restoril)

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?

Whether the client is experiencing drug intoxication or withdrawal

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:

a dose adjustment should be made if these symptoms persist.

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?

eszopiclone