Week 6 Pharmacology CNS Depressants
The nurse is reviewing medication therapy with the parents of an adolescent with ADHD. Which statement is correct? (Select all that apply.) "We will need to check your child's height and weight periodically to monitor physical growth." "This medication is used only when symptoms of ADHD are severe." "Be sure to have your child blow his nose before administering the nasal spray." "The last dose should be taken 4 to 6 hours before bedtime to avoid interference with sleep." "If adverse effects become severe, stop the medication for 3 to 4 days." "Be sure to contact the physician right away if you notice expression of suicidal thoughts."
"We will need to check your child's height and weight periodically to monitor physical growth." "The last dose should be taken 4 to 6 hours before bedtime to avoid interference with sleep." "Be sure to contact the physician right away if you notice expression of suicidal thoughts."
You are the nurse caring for a patient who has been prescribed zolpidem, a hypnotic CNS Depressant. You plan to administer this medication at this time in order to maximize its sleep-inducing effectiveness: 30-60 minutes before bedtime Immediately before bedtime 2 hours prior to bedtime With dinner
30-60 minutes before bedtime
In administering alprazolam to a client with COPD which of the following is a concern? Someone who has anxiety is more likely to have an exacerbation of a respiratory illness Alprazolam is contraindicated with medications used to treat COPD Alprazolam is a CNS depressant Anxiety and panic attacks can induce hyperventilation
Alprazolam is an CNS depressant
The nurse works in a pediatric psychiatry unit. Methylphenidate 5 mg 3 times daily is commonly prescribed for many of the clients. The nurse recognizes this drug needs to be used cautiously in which of the following children? A 6-year-old patient who takes montelukast daily An 8-year-old patient with a history of cardiovascular disease A 7-year-old patient with a history of sickle cell anemia A 12-year-old patient with a history of scoliosis
An 8-year-old patient with a history of cardiovascular disease
Based on your knowledge of this interaction, your first action is to: Advise him not to have food or beverages from home as they may interact with his medications. Assess his sedation level, respiratory effort, and vital signs. Prepare to administer flumazenil, the antidote to benzodiazepines. Advise him not to drink citric beverages.
Assess his sedation level, respiratory effort, and vital signs.
As the nurse caring for the patient taking a CNS Depressant, you are planning nursing interventions used to minimize some of the risks associated with this drug class, such as: (Select all that apply.) Teaching the patient to stop taking the medication once he's feeling better Teaching the patient to minimize alcohol use when taking this medication Assistance with ambulation To avoid driving while taking this medication
Assistance with ambulation To avoid driving while taking this medication
You are the nurse caring for Ed, a 51-year-old man with a history of hypertension, glaucoma, and Deep Vein Thrombosis (DVTs). He has been prescribed a benzodiazepine. Based on your knowledge of Ed's medical history, this drug class and its possible contraindications and drug-drug interactions, you know that: (Select all that apply.) Benzodiazepines are contraindicated in patients with narrow-angle glaucoma. Verapamil and diltiazem are antihypertensives that cause a decrease in benzodiazepine metabolism. Benzodiazepines interact with anticoagulants causing an increased risk for Deep Vein Thrombosis (DVTs). Benzodiazepines are contraindicated in patients with hypertension.
Benzodiazepines are contraindicated in patients with narrow-angle glaucoma. Verapamil and diltiazem are antihypertensives that cause a decrease in benzodiazepine metabolism.
Which of the following characteristics describe alprazolam? Nonbenzodiazepine CNS Depressant Barbiturate Sedative-hypnotic CNS Stimulant Anxiolytic Intermediate-acting benzodiazepine
CNS depressant sedative-hypnotic anxiolytic intermediate acting benzodiazepine
The patient has been prescribed methylphenidate for the treatment of narcolepsy. What priority teaching consideration(s) should be included for this patient? (Select all that apply.) Report any weight gain Caffeine should be avoided Avoid operating hazardous equipment Nervousness and tremors may occur Take the medication before meals
Caffeine should be avoided Avoid operating hazardous equipment Nervousness and tremors may occur Take the medication before meals
(Carisoprodol, Dantrium) has become a commonly abused drug, in particular in combination with an opioid and a benzodiazepine.
Carisoprodol
Benzodiazepines are contraindicated in pregnancy and lactation because they: (Select all that apply.) Cause CNS depression Cross into breastmilk May cause sedation and respiratory issues in newborns May cause anxiety in the mother
Cause CNS depression Cross into breastmilk May cause sedation and respiratory issues in newborns
Match the drug to the correct category of muscle relaxant: Centrally-acting Skeletal Muscle Relaxants Direct-acting Skeletal Muscle Relaxant baclofen chlorzoxazone cyclobenzaprine dantrolene carisoprodol
Centrally acting muscle relaxants baclofen carisoprodol chlorzoxazone cyclobenzaprine Direct-acting skeletal muscle relaxant dantrolene
Match the mechanism of action to the correct category of muscle relaxant: Centrally-acting Skeletal Muscle Relaxants Direct-acting Skeletal Muscle Relaxants •Provide sedative effects•Act directly on the CNS•Have no direct effects on the muscles•Have no effect on conduction of nerves•Act at the level of the brainstem and thalamus •Decrease the force of muscle contraction•Relax strained, stiff and weakened muscles •Small group of muscle relaxants•Act directly on skeletal muscle •Decrease the muscle's response to stimuli•Decrease the amount of calcium released
Centrally acting skeletal muscle relaxants provide sedative effects act directly on the CNS have no direct effects on the muscles have no effect on conduction of nerves act at the level of the brainstem, thalamus, basal ganglia, and spinal cord decrease the force of muscle contraction relax strained, stiff and weakened muscles Direct-acting skeletal muscle relaxants small group of muscle relaxants act directly on the excitation-contraction coupling of skeletal muscle fibers decrease the muscle's response to stimuli decrease the amount of calcium released
The patient has been prescribed methylphenidate for narcolepsy. The patient also has migraines and takes amitriptyline as a preventive. What should the nurse advise the patient to do before starting the new medication? "Immediately stop taking the amitriptyline." "Contact your primary health care provider to verify compatibility." "Increase fluid intake with the next meal." "Have baseline lab work drawn to assess liver function."
Contact your primary health care provider to verify compatibility
As the nurse caring for Martha the 80-year-old patient with arthritis taking cyclobenzaprine you ensure that you teach her which of the following in preparation for her discharge? (Select all that apply.) She should make sure to not stop taking this medication abruptly. This medication can cause painful urination so she should drink lots of fluids and let her health care provider know if this occurs. Do not stand up from a seated position too quickly so that you don't get dizzy. That we should see how she does on cyclobenzaprine for a few days before she goes back to driving.
Do not stand up from a seated position too quickly so that you don't get dizzy. That we should see how she does on cyclobenzaprine for a few days before she goes back to driving.
How might the dosage of alprazolam be adjusted in an elderly patient and why? Elderly patients have a much lower risk for dependency to benzodiazepines and therefore higher doses may be used in this population. Elderly patients are sensitive to benzodiazepines and therefore lower doses may be used in this population. Elderly patients are less sensitive to benzodiazepines and therefore higher doses may be used in this population. Elderly patients have a great risk for dependency to benzodiazepines and therefore lower doses may be used in this population.
Elderly patients are sensitive to benzodiazepines and therefore lower doses may be used in this population.
The patient is being treated with methylphenidate for ADHD. What common side/adverse effect(s) should the patient and family be informed might occur? (Select all that apply.) Orthostatic hypotension Euphoria Headache Vomiting Hypertension Irritability
Euphoria Headache Vomiting Hypertension Irritability
Which words/phrases describe the primary adverse effects of muscle relaxants that work on both the central nervous system and directly on skeletal muscles? Select all that apply. Fatigue Tachycardia Headaches Euphoria Drowsiness Gastrointestinal upset
Fatigue Euphoria Drowsiness
A patient at a weight management clinic who was given a prescription for orlistat calls the clinic hotline complaining of a "terrible side effect." The nurse suspects that the patient is referring to which problem? Fecal incontinence Sexual dysfunction Nausea Urinary incontinence
Fecal incontinence
Identify the applicable indications for the use of alprazolam: Generalized anxiety disorder (GAD) Insomnia Panic disorder Anxiety associated with depression Intraoperative amnesia Preoperative sedation
Generalized anxiety disorder (GAD) Panic disorder Anxiety associated with depression
Which of these are indications for the use of alprazolam? (Select all that apply.) Sedative to induce and maintain sleep Generalized anxiety disorder (GAD) Panic disorder Prevention of alcohol withdrawal Adjunct in the treatment of acute mania and acute psychosis Anxiety associated with depression
Generalized anxiety disorder (GAD) Panic disorder Adjunct in the treatment of acute mania and acute psychosis Anxiety associated with depression
The nurse is providing care to a 9-year-old boy admitted with a broken tibia. The child takes amphetamine/dextroamphetamine 20 mg/day. The healthcare provider has prescribed meperidine 25 mg IM every 4 hours as needed for pain. Which of the following actions by the nurse is best? Hold the meperidine and contact the healthcare provider. Hold the adderall. Notify the charge nurse. Give the meperidine if the child complains of pain.
Hold the meperidine and contact the healthcare provider.
Select the true statement below regarding sedative-hypnotics. Hypnotics at low doses calm the CNS without causing sleep. Sedatives at low doses calm the CNS and cause sleep. Hypnotics at high doses calm the CNS and cause sleep. Sedatives at high doses calm the CNS without causing sleep.
Hypnotics at high doses calm the CNS and cause sleep.
The nurse is caring for a patient who takes dextroamphetamine. The nurse should be most concerned by which of the following patient statements? "I forgot to take my medication in the morning last week so I took it at lunch time." "I seem to be able to focus better and I'm less distracted now." "I started taking St. John's wort this week to help with my depression." "I've been having some trouble falling asleep at night lately."
I started taking St. John's wort this week to help with my depression.
Which statements are true of methylphenidate? (Select all that apply.) If taken with monoamine oxidase inhibitors (MAOIs), it may increase a hypertensive crisis There may be increased effects if taken with caffeinated beverages Insulin will be more effective The effects of anticoagulants may increase Hyperglycemia may occur
If taken with monoamine oxidase inhibitors (MAOIs), it may increase a hypertensive crisis There may be increased effects if taken with caffeinated beverages The effects of anticoagulants may increase
The nurse is developing a plan of care for a patient receiving an anorexiant. Which nursing diagnosis is most appropriate? Impaired memory Deficient fluid volume Imbalanced nutrition, less than body requirements Sleep deprivation
Imbalanced nutrition, less than body requirements
Intermediate-acting benzodiazepines are so called because: In relation to short- and long-acting benzodiazepines, their onset and duration of action take place over a period of time that is neither fast nor slow They are sometimes less effective when taken with other CNS Depressants They sometimes have an increased CNS depressive effect when taken with barbiturates There onset and duration of action takes much longer than those of short-acting benzodiazepines
In relation to short- and long-acting benzodiazepines, their onset and duration of action take place over a period of time that is neither fast nor slow
Choose all the statements below that are correct regarding Benzodiazepines. (Select all that apply.) Produce more REM suppression than barbiturates clonazepam, diazepam, and flurazepam are short-acting benzodiazepine Affect the hypothalamic, thalamic, and limbic systems of the brain (GABA receptors) alprazolam, lorazepam, and temazepam are long-acting benzodiazepines Induce relaxation of skeletal muscles Reduce excessive sensory stimulation which induces sleeps
Induce relaxation of skeletal muscles Reduce excessive sensory stimulation which induces sleeps Affect the hypothalamic, thalamic, and limbic systems of the brain (GABA receptors)
CNS stimulants are absolutely contraindicated for patients with a history of which condition(s)? (Select all that apply.) Liver failure Hypertension Hypothyroidism Diabetes Coronary artery disease
Liver failure Hypertension coronary artery disease
Muscle relaxants are indicated for the use of: (Select all that apply.) Low back strain Insomnia Pre-operative adjunct to anesthesia Cerebral palsy Arthritis Parkinson's Disease Treatment of withdrawal symptoms Multiple sclerosis Anxiety-related depression
Low back strain Cerebral palsy Arthritis Parkinson's Disease Multiple sclerosis
You are the nurse caring for Martha, an 80-year-old patient with arthritis who has started taking cyclobenzaprine. Your nursing assessment pays special attention to ________ (Select all that apply.) Martha's urine output. Martha's body temperature. Martha's sedation level. Martha's fall risk.
Martha's sedation level Martha's fall risk
Which of the following medications are used to treat ADHD? Methylphenidate Benzphetamine Modafinil Atomoxetine Phendimetrazine
Methylphenidate Atomoxetine
The nurse is teaching a patient to self-administer medications. The nurse knows that which drugs can be used to treat narcolepsy? (Select all that apply.) Atomoxetine Lisdexamfetamine Methylphenidate Modafinil
Methylphenidate Modafinil
Which of the following medications are used to treat obstructive sleep apnea? Atomoxetine Methylphenidate Phendimetrazine Modafinil Benzphetamine
Modafinil
Which medical condition(s) is/are central nervous system (CNS) stimulants approved to treat? (Select all that apply.) Narcolepsy Post traumatic stress disorder Attention deficit/hyperactivity disorder (ADHD) Obesity Anorexia
Narcolepsy Attention deficit/hyperactivity disorder (ADHD) obesity
A patient with narcolepsy will begin treatment with a CNS stimulant. The nurse expects to see which adverse effect? Drowsiness at night Nervousness Mental clouding Bradycardia
Nervousness
__________ is the clinical indication for theophylline. ADHD Anorexia Preterm apnea Migraines
Preterm apnea
Choose the correct statement(s) below regarding sedative-hypnotics. (Select all that apply.) Prolonged use of sedative-hypnotics can cause REM rebound resulting in too much REM sleep and frequent, vivid dreams. Prolonged use of sedative-hypnotics can cause REM interference resulting in daytime fatigue. Discontinuation of a sedative-hypnotic can cause REM interference resulting in daytime fatigue. Discontinuation of a sedative-hypnotic can cause REM rebound resulting in too much REM sleep and frequent, vivid dreams.
Prolonged use of sedative-hypnotics can cause REM interference resulting in daytime fatigue. Discontinuation of a sedative-hypnotic can cause REM rebound resulting in too much REM sleep and frequent, vivid dreams.
You are caring for a patient taking a CNS Depressant. You are considering your plan of care for this patient based on the subjective and objective data you have collected, as well as your knowledge of this drug class. You choose the following as the priority focus for your nursing care: Risk for injury Respiratory depression Confusion Drug dependence
Respiratory depression
The nurse is preparing discharge instructions for a client being sent home with a prescription for a benzodiazepine. Match the following instructions to the potential risks of this medication class. Risk for Injury Risk for Sedation Risk for Dependence •Avoid driving or operating heavy machinery• May be higher risk for falls •Can cause confusion or memory loss •Do not use with kava or valerian root• Do not use with alcohol or opioids• Do not use with sleep aids •Do not stop taking abruptly after prolonged use• Many CNS depressants are controlled substances
Risk for Injury: •Avoid driving or operating heavy machinery• May be higher risk for falls •Can cause confusion or memory loss Risk for Sedation: •Do not use with kava or valerian root• Do not use with alcohol or opioids• Do not use with sleep aids Risk for Dependence: •Do not stop taking abruptly after prolonged use• Many CNS depressants are controlled substances
In reviewing benzodiazepine use in an elderly client, you anticipate: (Select all that apply.) Decreased CNS depressive effects Risk of low respiratory rate and excessive sedation Increased CNS depressive effects Insomnia and tachycardia
Risk of low respiratory rate and excessive sedation Increased CNS depressive effects
You are the nurse caring for Sara, a 34-year-old patient who has come to the ER with complaints of confusion, restlessness and an increase in muscle spasms. In completing her admission history and assessment, you note that included in her medication list is cyclobenzaprine. Aside from this change in neurological status, her physical assessment is within normal limits. Based on this information and your knowledge of this drug class, you suspect that ________ Sara has taken an overdose of cyclobenzaprine. Sara is experiencing alcohol withdrawal brought on by the cyclobenzaprine. Sara stopped taking her cyclobenzaprine abruptly. Sara has mixed her cyclobenzaprine with another CNS depressant.
Sara stopped taking her cyclobenzaprine abruptly.
You are the nurse caring for a patient taking a muscle relaxant. Although you know that muscle relaxants are used for the treatment of muscle spasms and pain, they are still types of CNS depressants. For this reason, you assess for some of the effects of CNS depressants in which of these situations? Sedative effects such as drowsiness, dizziness if taking cyclobenzaprine Relief of insomnia if taking baclofen Relief of muscle spasm associated with malignant hyperthermia Sedative effects such as drowsiness and dizziness if taking dantrolene
Sedative effects such as drowsiness, dizziness if taking cyclobenzaprine
A patient has a new prescription for sumatriptan. The nurse providing patient teaching on self-administration will include which information? Take no more than 4 doses in a 24-hour period Take the medication before the headache worsens Allow at least 30 minutes between injections Correct technique for IM injections
Take the medication before the headache worsens
Which of the following statements are true regarding barbiturates? (Select all that apply.) The long-term use of barbiturates can lead to harmful effects on sleep due to the deprivation of REM sleep. Overdose of barbiturates typically leads to respiratory arrest, coma, and death. Barbiturates are a type of sedative-hypnotic. MAOIs (antidepressants) result in a longer duration of action of barbiturates. Decreased CNS depression occurs when administered with alcohol, antihistamines, benzodiazepines, opioids and tranquilizers. Increased CNS depression occurs when administered with alcohol, antihistamines, benzodiazepines, opioids and tranquilizers. The long-term use of barbiturates can lead to harmful effects on sleep due to the prolongation of REM sleep.
The long-term use of barbiturates can lead to harmful effects on sleep due to the deprivation of REM sleep. Overdose of barbiturates typically leads to respiratory arrest, coma, and death. Barbiturates are a type of sedative-hypnotic. MAOIs (antidepressants) result in a longer duration of action of barbiturates. . Increased CNS depression occurs when administered with alcohol, antihistamines, benzodiazepines, opioids and tranquilizers.
Select the true statement(s) regarding CNS depressants. (Select all that apply.) There are significant drug-drug interactions with benzodiazepines, especially with other CNS Depressants, due to the intensity of benzodiazepines and the combined CNS depressant effects. There is a black box warning regarding the combination of all opioids with all benzodiazepines which can cause serious CNS depression (extreme sleepiness, respiratory depression, coma and death). Herbal supplements kava and valerian have CNS stimulant effects. Alcohol should not be used with these CNS Depressants because the combination multiples the CNS depressive effects.
There are significant drug-drug interactions with benzodiazepines, especially with other CNS Depressants, due to the intensity of benzodiazepines and the combined CNS depressant effects. There is a black box warning regarding the combination of all opioids with all benzodiazepines which can cause serious CNS depression (extreme sleepiness, respiratory depression, coma and death). Alcohol should not be used with these CNS Depressants because the combination multiples the CNS depressive effects.
As the nurse caring for a patient taking cyclobenzaprine, a centrally acting muscle relaxant, you ensure that you teach the patient which of the following in preparation for discharge? They will be taking this medication for the next few years. They should see how they do on cyclobenzaprine for a few days before they go back to driving. If they experience any of the side effects discussed, it is best to stop taking the medication immediately. They should reach maximum therapeutic benefits from this medication in the next 1-2 days.
They should see how they do on cyclobenzaprine for a few days before they go back to driving.
A patient taking alprazolam, or any CNS Depressant, should avoid which of the following? (Select all that apply.) Green tea Valerian root Grapefruit juice Kava
Valerian root Grapefruit juice Kava
Nonbenzodiazepines act on the CNS (but do not act like benzodiazepines, and act very much like benzodiazepines). Orexin Receptor Antagonists (also called hypocretins) act on the CNS and (act very much like benzodiazepines, but do not act like benzodiazepines).
act very much like benzodiazepines act very much like benzodiazepines
You are the nurse caring for a patient taking cyclobenzaprine, a centrally acting skeletal muscle relaxant. He asks you why he must not drink alcohol while taking this medication. Your response is that ___________ alcohol and this medication both cause CNS depression. alcohol can cause insomnia. alcohol makes this medication less effective. alcohol causes issues with the liver which can be impaired by this medication.
alcohol and this medication both cause CNS depression
As with (some, all) CNS Depressants, there is a potential for adverse effects and toxicity or overdose when muscle relaxants are taken with (anesthetics, other CNS depressive substances and drugs) .Muscle relaxant overdose requires( more, less) aggressive treatment than does an overdose of other CNS Depressants. The priority is the ABCs, including airway maintenance, heart rhythm monitoring, and IV fluids.
all other CNS depressive substances and rugs more
Which of these medications is an intermediate-acting benzodiazepines used for its anxiolytic effects? alprazolam diazepam zolpidem butabarbital
alprazolam
You are the nurse caring for Sara, a 25-year-old female patient for whom suvorexant is prescribed. Based on your knowledge of this medication, you are aware that she may experience: Decreased effectiveness of this medication while lactating An increased risk for daytime sleepiness Insomnia Excessive CNS stimulation
an increased risk for daytime sleepiness
Benzodiazepines are most often used for which of these effects? Hypnotic Anxiolytic Sedative Barbiturate
anxiolytic
You are the nurse caring for Stephanie, a 42-year-old woman for whom you are completing discharge instructions and patient teaching. She has been prescribed a nonbenzodiazepine. However, she mentioned to you during your conversation that she is allergic to acetylsalicylic acid. You tell Stephanie that those with an allergy to acetylsalicylic acid (are more likely to have an allergy to, will likely not have therapeutic results) with nonbenzodiazepines.
are more likely to have an allergy to
The nurse caring for a patient prescribed a muscle relaxant is aware that, in addition to most of the side effects associated with all CNS Depressants, the assessment of this patient will include (a thorough history of sleep patterns and issues, awareness of muscle function, pain, and range of motion).
awareness of muscle function, pain and range of motion
Which of the following muscle relaxants is used to treat muscle spasms and can be used in an implantable pump device? dantrolene metaxalone cyclobenzaprine baclofen
baclofen
The patient is born at 28 weeks gestation and is scheduled to receive caffeine citrate 20 mg IV shortly after birth. The patient's mother asks, "Why are you giving my baby stuff that is in coffee?" What is the nurse's best response? "The baby's temperature will be warmer with caffeine." "Caffeine can help your baby breathe better." "It will help your baby gain weight faster." "This isn't the same substance that is in coffee."
caffeine can help your baby breathe better
The nurse is reviewing the history of a patient who will be starting triptan sumatriptan (Imitrex) as part of treatment for migraine headaches. Which condition, if present, may be a contraindication to triptan therapy? Chronic bronchitis Cardiovascular disease History of renal calculi Diabetes mellitus type 2
cardiovascular disease
Which of these muscle relaxants is commonly abused in combination with an opioid and a benzodiazepine, together referred to as "The Holy Trinity", producing a heroin-like effect? carisoprodol dantrolene cyclobenzaprine chlorzoxazone
carisoprodol
Benzodiazepines are contraindicated in pregnancy because (they interact with prenatal vitamins, cause CNS depression). This can subsequently lead to (congenital abnormalities, respiratory issues) in the neonate.
cause CNS depression respiratory issues
When reviewing a client's medications for discharge, she asks you if she can continue to take kava for her insomnia. You understand that kava. only interacts with other prescription CNS depressants will make her CNS depressant ineffective causes CNS depression will help CNS depressant medication be more effective
causes CNS depression
The pediatric patient has been started on methylphenidate for ADHD. What information should the nurse include in the health teaching? Constipation is a common side effect This medication will only be used for a few weeks Weight gain is to be expected Counseling should be combined with medication
counseling should be combined with medication
For which of these muscle relaxants is marked sedation a common result of use? dantrolene cyclobenzaprine baclofen carisoprodol
cyclobenzaprine
Which of the following is a direct acting skeletal muscle relaxant? baclofen cyclobenzaprine tizanidine dantrolene
dantrolene
Which of these muscle relaxants in IV form is used to treat skeletal muscle spasms caused by malignant hyperthermia? cyclobenzaprine baclofen methocarbamol dantrolene
dantrolene
Muscle relaxants and other CNS Depressants have (the same, different) indications for use including insomnia and sedation.
different
As the nurse caring for a patient taking a CNS Depressant. Which adverse effect does the nurse need to consider when assessing a client prescribed a CNS depressant? Hypertension Nausea and vomiting Insomnia Excessive sedation
excessive sedation
The 18-year-old patient is brought to the emergency room department by her roommates. Her blood pressure is 220/136 mm Hg, heart rate 142 beats/minute, and respiratory rate 20 breaths/minute. She is responsive only to deep pain. Her roommates say she has been trying to lose weight and has been taking "these pills she gets over the Internet." What will the nurse consider as the most likely cause for this patient's symptoms? Food poisoning Cardiac arrest Pregnancy-induced hypertension Hemorrhagic stroke
hemorrhagic stroke
The nurse is developing a plan of care for a patient receiving an anorexiant. Which nursing diagnosis is most appropriate? Sleep deprivation Imbalanced nutrition, less than body requirements Deficient fluid volume Impaired memory
imbalanced nutrition, less than body requirements
Nicotine causes (increased, decreased) benzodiazepine (potency, metabolism) which causes the medication to be (less effective, overly potent). For a patient who is a smoker and is also taking alprazolam for generalized anxiety disorder, this could mean that their symptoms of anxiety (do not improve, worsen).
increased metabolism less effective do not improve
You are caring for a patient who has been brought to the ER with the following symptoms: hypotension, bradypnea, diminished reflexes, and extreme drowsiness. Her husband discusses her medical history and medication list with the healthcare team. He reports that she has been taking a muscle relaxant prescribed for a chronic musculoskeletal condition. Based on this information and your knowledge of this drug class, you ______ (Select all that apply.) inquire if she stopped taking the medication suddenly. inquire how much caffeine she consumes daily. inquire whether or not she has consumed alcohol recently. inquire whether or not she has been taking any herbal or non-prescription supplements and, if so, which ones.
inquire whether or not she has consumed alcohol recently. inquire whether or not she has been taking any herbal or non-prescription supplements and, if so, which ones.
You are caring for a patient for whom you have an order to administer a barbiturate. Based on your knowledge of this subclass and its contraindications, you check the patient's lab results to ensure that she is (not anemic, is not pregnant).
is not pregnant
Muscle relaxants are categorized by their (mechanism of action, impact on the CNS).
mechanism of action
Which of the following medications would you anticipate prescribed for a patient with narcolepsy? Select all that apply. biculline methylphenidate strychnine methamphetamine dextroamphetamine
methylphenidate methamphetamine dextroamphetamine
Which of the following items have CNS depressive effects and should be used with caution in patients taking alprazolam? (Select all that apply.) muscle relaxants anxiolytics antipsychotics benzodiazepines flumazenil caffeine alcohol opioids
muscle relaxants anxiolytics antipsychotics benzodiazepines alcohol opioids
The reversal drug for muscle relaxant overdose is which of the following? temazepam flumazenil muscle relaxants do not have a specific antidote or reversal drug for an overdose zolpidem
muscle relaxants do not have a specific antidote or reversal drug for an overdose
As the nurse caring for a patient taking a muscle relaxant, you are aware of the side effects general to all CNS depressants and those specific to muscle relaxants such as drowsiness. muscle spasticity, pain and stiffness. risk for excessive CNS depression. Insomnia.
muscle spasticity, pain, and stiffness
Which of the following are currently the more frequently prescribed sedative-hypnotic drugs? Ultrashort-acting barbiturates Long-acting barbiturates Benzodiazepines Nonbenzodiazepines
nonbenzodiazepines
alprazolam is a/an (oral, parenteral) (barbiturate, benzodiazepine) used for its (anxiolytic, hypnotic) effects by reducing (insomnia, anxiety).
oral benzodiazepine anxiolytic anxiety
alprazolam is administered (Oral (PO), Intramuscular (IM), Intravenous (IV))
oral (PO)
Muscle relaxants are found to be the most effective when combined with ____________. an opioid physical therapy a benzodiazepine a CNS Stimulant
physical therapy
A new nurse is admitting a patient who has received doxapram. The nurse recognizes that this is which type of medication? Postanesthetic respiratory stimulant Narcotic antagonist Long-acting narcotic Inhaled respiratory stimulant
postanesthetic respiratory stimulant
You are caring for a patient hospitalized for muscle spasms associated with multiple sclerosis. Her health care provider is prescribing baclofen for long term use. Based on your knowledge of this medication, which of the following you would consider? (Select all that apply.) prepare the patient for an implantable baclofen pump device. explain to this patient that she is being administered a medication that will cause her to feel agitated and excitable. begin closely monitoring the patient's temperature. prepare to administer a test dose as ordered by the health care provider.
prepare the patient for an implantable baclofen pump device. prepare to administer a test dose as ordered by the health care provider.
You are the nurse caring for Tammy, a 35-year-old woman who has just arrived at your unit from post-op. She is exhibiting signs of malignant hyperthermia and her health care provider has ordered a direct acting skeletal muscle relaxant for treatment. Based on your knowledge of this type of medication and its indication for this use, you _____ prepare to administer cyclobenzaprine and monitor her sedation level, heart rhythm, vital signs, electrolyte levels, and urine output continuously. prepare to administer dantrolene and monitor her heart rhythm, vital signs, electrolyte levels, and urine output continuously. prepare to administer baclofen and monitor her heart rhythm, vital signs, electrolyte levels, and urine output continuously. prepare to administer dantrolene and monitor her sedation level, heart rhythm, vital signs, electrolyte levels, and urine output continuously.
prepare to administer dantrolene and monitor her heart rhythm, vital signs, electrolyte levels, and urine output continuously.
You are the nurse caring for a patient who has been diagnosed with Parkinson's disease and is prescribed a centrally acting skeletal muscle relaxant. Based on your knowledge of this drug class and its indications for use, you assess the patient for therapeutic affects such as reduction of anxiety associated with the new diagnosis. reduction of the rigidity associated with Parkinson's disease. marked sedation that results from all muscle relaxants. reduction of muscle pain associated with Parkinson's disease.
reduction of the rigidity associated with Parkinson's disease
You are the nurse caring for a patient taking dantrolene for malignant hyperthermia resulting from a recent surgical procedure. Your assessment of this patient will include areas specific to this drug's mechanism of action and malignant hyperthermia. These areas include relief of muscle rigidity associated with malignant hyperthermia. respiratory depression associated with all CNS depressants. successful induction of sleep associated with the hypnotic effects of dantrolene. cardiovascular depression associated with all CNS depressants.
relief of muscle rigidity associated with malignant hyperthermia.
A nurse is completing an assessment of a patient taking a CNS Depressant medication. The nurse will monitor for symptoms of CNS depression such as (respiratory depression, rebound hypertension) associated with the inhibition of nerve impulse transmission to the CNS.
respiratory depression
You are the nurse caring for a patient who is taking cyclobenzaprine following an injury. You are completing discharge teaching with your patient which includes information regarding his medication. You explain to him that ________ he may need to increase the dosage over time as tolerance develops. insomnia is a common side effect. this medication only works for about 2 hours at a time. sedation is a common side effect.
sedation is a common side effect
Antiepileptics are used for the long-term maintenance treatment of what condition? Seizures Uncontrolled coughing Pyrexia Fluid overload
seizures
You are the nurse caring for a patient taking pentobarbital, a short-acting barbiturate. Based on your knowledge of the indications for this medication, you know that this patient may have a history of (seizures, depression).
seizures
The patient has a history of migraines, depression, and hypertension and has been started on phentermine-topiramate. For which condition is phentermine-topiramate used? Asthma Short-term weight management Narcolepsy ADHD
short-term weight managment
You are caring for a patient who has come into the ER with complaints of muscle spasms and pain following an injury. He had been discharged yesterday for the same complaint with a prescription for a muscle relaxant. Based on your knowledge of this drug class, you know that: there was an error made by the healthcare provider who wrote the prescription. the patient has not allowed enough time for the medication to take effect. the patient's muscle spasms have worsened because the medication should have taken effect. the patient has become physically dependent on the medication and it is no longer effective at this dose.
the patient has not allowed enough time for the medication to take effect.
A newborn patient is in respiratory distress. The nurse anticipates preparation for which medication to be given? modafinil theophylline armodafinil amphetamine
theophylline
Safety of a drug is determined by the degree between: Therapeutic and toxic doses Potency and efficacy Side and adverse effects Subtherapeutic and toxic levels
therapeutic and toxic doses
In educating clients taking benzodiazepines with other CNS depressants, the nurse indicates this may put the client at risk for (dependence, toxicity).
toxicity
To maintain the half-life of methylphenidate, how often should this medication be taken? Every other day Twice a day Daily Three times per day
twice a day
The nurse caring for a patient prescribed a muscle relaxant is aware that there are two categories, each with a mechanism of action and subsequent nursing implications that are (the same as all other CNS depressants, unique to this subclass).
unique to this subclass
A child with ADHD is prescribed atomoxetine. What negative side effects would the nurse assess closely for? (Select all that apply.) Weight loss Improved social behavior Improvement in school grades Suicidal thoughts Increased focus
weight loss suicidal thoughts
