Evolve Pharm Chapter 12

What are contraindications to the administration of barbiturates? Select all that apply.

- pregnancy - drug allergy - significant respiratory difficulties

How is flumazenil (Romazicon) administered when treating diazepam (Valium) overdose?

0.2 mg (2 mL) IV over 30 seconds

A health care provider prescribes a preoperative sedative to be given by the intramuscular (IM) route to a child who is scheduled for surgery. What dose of phenobarbital (Barbinol) does the nurse expect the health care provider to prescribe for the child?

1 to 3 mg/kg as a single dose

The nurse observes that a patient who is receiving phenobarbital (Nembutal) has clammy skin and a respiratory rate of 5 breaths/min. The provider orders a phenobarbital level. Which level will the nurse anticipate in this patient?

43 mcg/mL

The nurse is teaching a group of nursing students about the stages of non-rapid eye movement (non-REM) sleep. Which is the third stage of sleep?

Deep sleep

A patient reports swelling at the site of infusion of intravenous (IV) pentobarbital (Nembutal). Which event does the nurse suspect as the cause of swelling?

Intravenous infiltration

Which category of phenobarbital is most commonly used in the treatment of epilepsy?

Long-acting barbiturates

A patient is admitted to the hospital after a suspected overdose of barbiturates. What is the priority treatment approach for the patient?

Maintenance of an adequate airway

A patient is admitted to the hospital after a suspected overdose of barbiturates. What is the priority treatment approach for this patient?

Maintenance of an adequate airway

Which benzodiazepine has rapid onset, is short acting, relieves anxiety, and provides sedation before and during procedures?

Midazolam (Versed)

Which medication is beneficial for reducing pre-surgery anxiety and decreasing the patient's ability to remember the uncomfortable medical procedure?

Midazolam (Versed)

Which is the most important nursing intervention while caring for a teenage patient who is on benzodiazepine therapy?

Monitoring for suicidal tendencies

What is the result of a potential drug interaction between benzodiazepines and rifampin?

Decreased benzodiazepine effects

The nurse observes that a patient who was prescribed methohexital (Brevital) has Cheyne-Stokes respirations and hypoventilation. What will the nurse expect the provider to order to treat this patient?

Activated charcoal every 4 hours

The nurse notices that a patient has taken an excessive dose of baclofen (Lioresal). Which action does the nurse implement immediately?

Airway maintenance

A patient has been prescribed eszopiclone (Lunesta). The nurse educates the patient to safely take the medication. Which instruction will the nurse include in patient teaching?

Allow at least 8 hours for sleep.

Midazolam (Versed) has been ordered for a patient to be administered by intravenous injection 2 minutes prior to a colonoscopy. The nurse informs the patient that one of the most common side effects of this medication is which effect?

Amnesia

A patient asks the nurse whether she may take diazepam (Valium) to help her sleep at night. Which information should the nurse include in patient teaching to help prevent adverse effects of diazepam (Valium)?

Avoid using this drug to induce sleep.

Which drug is derived from gamma-aminobutyric acid (GABA) and reduces muscle spasticity?

Baclofen

A patient with multiple sclerosis participates in a rehabilitation program. The patient takes baclofen (Lioresal) to help manage muscle spasticity. How will the baclofen (Lioresal) interfere with the patient's rehabilitation activities?

By producing drowsiness, lethargy, and blurred vision

Dantrolene (Dantrium) acts on the sarcoplasmic reticulum in the treatment of malignant hyperthermia. What does it help to block?

Calcium Calcium

Thiopental (Pentothal)

Drug allergy

Why is diazepam used for the treatment and prevention of alcohol withdrawal symptoms?

Due to the presence of benzodiazepine receptors adjacent to the receptors responsible for alcohol addiction

The nurse is assessing a patient who reports having insomnia. On further assessment, the nurse finds that the patient has been taking verapamil (Calan) for hypertension. What type of medication does the nurse expect the primary health care provider to prescribe for the insomnia?

Eszopiclone (Lunesta)

Which drug is used as an antidote for overdose of oral benzodiazepine or excessive intravenous sedation?

Flumazenil

While assessing a patient who has been administered midazolam (Versed), the nurse finds that the patient's blood pressure is very low. Which prescription will the nurse discuss with the primary health care provider?

Flumazenil (Anexate) at a maximum dose of 3 mg

Which barbiturate has a short duration of action?

Pentobarbital (Nembutal)

Which central nervous system (CNS) depressant may also be used for treatment of hyperbilirubinemia in neonates?

Phenobarbital (Luminal)

Which nursing intervention may be particularly beneficial to an African-American patient with insomnia?

Recommending that the patient consume a glass of warm lactose-free milk at bedtime

Which nursing diagnosis is appropriate for a patient who has received a sedative-hypnotic drug?

Risk for injury

Which is a side effect of the nonbenzodiazepine drug zolpidem (Ambien)?

Sleepwalking

An Asian patient reports unusual sleep patterns and lack of sleep.The nurse asks the patient to drink warm milk before going to sleep. However, the patient develops diarrhea. What is the best non-pharmacological nursing intervention to promote patient comfort?

Suggest drinking lactose-free milk at bedtime.

When teaching a patient about temazepam (Restoril), the nurse advises the patient to take it 1 hour prior to going to bed. Why does the nurse give this advice to the patient?

Temazepam (Restoril) induces sleep in approximately 1 hour.

Which parameter determines whether a drug is classified as a sedative or hypnotic?

The degree of inhibition of nerve impulse transmission to the CNS.

A patient is brought to the trauma care unit for administration of activated charcoal via a nasogastric tube every 4 hours. What may be the reason for this?

The patient is experiencing a barbiturate overdose.

A patient who has difficulty sleeping has been prescribed diazepam (Valium). On the follow-up assessment, the nurse finds that the patient has prolonged sleep. What is the reason for the prolonged sleep?

The patient takes grapefruit juice along with diazepam (Valium).

A patient is scheduled for a brief surgical procedure. Which drug does the nurse expect to be used during surgery?

Thiopental (Pentothal)

Which is the characteristic feature of rapid eye movement (REM) rebound sleep?

Vivid dreams

A patient is admitted to the emergency department after taking an overdose of a barbiturate 15 minutes prior to arrival. The nurse can anticipate that which drug will be prescribed?

activated charcoal

A patient is admitted to the emergency department with a severe overdose of a benzodiazepine. The nurse immediately prepares to administer which antidote from the emergency drug cart?

flumazenil (Romazicon)