Chapter 20: Anxiolytic and Hypnotic Agents

Zolpidem (Ambien) is prescribed for a hospitalized client having difficulty falling asleep at night. What is the best time for the nurse to administer this medication?

11 PM

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

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

Provide respiratory assistance

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."

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

"It will not produce sedation like benzodiazepines."

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

eszopiclone (Lunesta)

The nurse notices during a well-child checkup that an infant has been losing weight and is lethargic. The mother is breast-feeding the child. Which medication should the nurse question the mother taking? (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

What are the most important physical assessments for a nurse to perform when admitting a client diagnosed with elevated blood pressure due to anxiety? (Select all that apply.)

Blood pressure Respiratory rate Skin temperature and color

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?

Buspirone

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

Buspirone (BuSpar)

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?

Client is diagnosed with hepatitis C.

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

Comatose client

An elderly patient is administered a sedative for the treatment of insomnia. Which sign should the nurse look for in the patient when monitoring the effects of the administered drug?

Confusion

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

Depression of the cerebral cortex

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

Diazepam (Valium)

Patients taking benzodiazepines, especially elderly patients, are at high risk for:

Falls

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

False

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

False

Barbiturates are considered the sedative and hypnotic drugs of choice

False

Which action would be least appropriate for the nurse to do after administering an anxiolytic to a patient?

Having the patient walk to the bathroom

A nurse should recognize which as common early reactions caused by anxiolytics? (Select all that apply.)

Headache Sedation Light-headedness Dizziness

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

Increased risk for falls

A patient who suffers from GERD and diverticulosis has just been admitted to a medical floor. The admitting physician orders cimetadine and a sedative to calm the patient. About what should the nurse be concerned?

Increased sedative effect

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

Induces sleep

The medication nurse knows that when benzodiazepines are used with opioid analgesics, the analgesic dose should be adjusted in which way?

It should be reduced initially and increased gradually.

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

Pentobarbital (Nembutal) Secobarbital (Seconal)

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

Phenobarbital

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 back rubs

A patient receiving halcion 0.25 mg PO at bedtime appears very drowsy and is difficult to rouse when the nurse enters the room. Based on these findings, what would be the best nursing diagnosis for this patient? You Selected:

Risk for injury

A client is ordered to receive diazepam as part of the treatment for status epilepticus. The client has an intravenous (IV) infusion running, which is being used to administer another drug for seizure control. The IV line is in the client's left arm. Which action by the nurse would be most appropriate?

Start another IV line in the client's right arm.

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 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 truck driver has been diagnosed with a generalized anxiety disorder (GAD) and lorazepam has been prescribed. The patient asked the nurse how this medication will affect his job. The nurse advised him to:

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.

The prototype for benzodiazepines is:

diazepam.

A decrease in dosage of a prescribed benzodiazepine most likely would be necessary if a client was also taking:

oral contraceptive.

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 34-year-old executive for an insurance company has been taking lorazepam for the last 6 months for anxiety. The client abruptly stopped the medication. The client then calls the physician and reports feeling irritable, increased heart rate, and restlessness. What would explain the client's current symptoms?

withdrawal from stopping the medication