Pharm Ch.20 PrepU

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 disease

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

A nurse is planning teaching with a client who has had an anti-anxiety medication prescribed. A priority action for would be to:

try to identify and avoid factors that cause nervousness or insomnia.

The healthcare provider has prescribed alprazolam (Xanax) for a client. After the nurse has taught the client about this medication. The nurse confirms that the client understands the drug's action when the client makes which statement?

"I may be a little drowsy at first when I start taking this medication."

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.

"Are you currently taking any medications?"

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 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."

What assessment question would be most appropriate when providing care for a client newly prescribed chlordiazepoxide?

"When did you have your last drink of alcohol?"

Long-term use of which anxiolytics can result in physical or psychological dependence? (Select all that apply.)

*Alprazolam (Xanax) *Chlordiazepoxide (Librium)

The nurse is doing a physical assessment on admission of a client diagnosed with elevated blood pressure due to anxiety. What are the most important physical assessments for a nurse to perform? Select all that apply.

*Blood pressure *Respiratory rate *Skin temperature and color

A nurse is caring for a client who is prescribed barbiturates. The nurse would assess the client for which of the following? Select all that apply.

*CNS depression *Mood alteration *Hypnosis

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

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

An older adult client is prescribed a hypnotic. The nurse would assess the client closely for which of the following? Select all that apply.

*Excitement *Ataxia *Confusion

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

Zolpidem is prescribed for a hospitalized 58-year-old client having difficulty falling asleep at night. What is the best time for the nurse to administer this medication?

9 PM

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

Abnormal anxiety is prolonged and impairs normal function.

A client has been admitted to the emergency department in convulsions and been prescribed 200 mg amobarbital (Amytal sodium) IV STAT. What is the nurse's best action?

Administer the medication and monitor the client's status closely

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

The nurse is caring for a client treated with flumazenil for benzodiazepine toxicity. After administering flumazenil what should the nurse carefully assess for?

Agitation, confusion, and seizures

What might occur if a client inadvertently receives a benzodiazepine intra-arterially?

Arteriospasm

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 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.

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

Blood pressure

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

Buspirone

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

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

Chronic pain

A nurse obtains a health history from a client who has been prescribed temazepam. 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 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 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 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?

Difficulty falling asleep at night

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

Falls

An older adult client diagnosed with generalized anxiety disorder is prescribed a benzodiazepine. The nurse caring for the client knows to include what intervention in the client's care plan?

Falls risk assessment

A nurse is caring for a patient who is being administered alprazolam. What initial adverse reaction of alprazolam should the nurse assess for?

Headache

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 central nervous system depression

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

Induces sleep

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

Insomnia

Buspirone has been prescribed for a client with anxiety. When providing health education, the nurse should describe what benefit of this medication over other anxiolytics?

Less central nervous system depression

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?

Monitor for increased signs of confusion or forgetfulness.

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

Provide respiratory assistance

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?

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

What goal should the nurse identify for a client prescribed chlordiazepoxide?

The client will not appear restless or confused.

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 benzodiazepine is prescribed for a pregnant woman with insomnia. When describing the effects on the newborn, which would the nurse include?

The newborn can develop withdrawal symptoms.

A male patient is being discharged home from the hospital after having pneumonia. At home, the patient will be taking the same drugs he was taking before he was hospitalized. These drugs include an anti-anxiety medication and a medication for insomnia. During the home care nurse's initial visit, what should the nurse review with the patient?

The risks of injuries if mental and physical responses are slowed by drugs

Barbiturates are considered the sedative and hypnotic drugs of choice.

True

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

The client reports using an over-the-counter (OTC) drug to treat insomnia. What classification of OTC medications is often used for this purpose?

antihistamines

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?

anxiety

Which medications are capable of central nervous system depression, hypnosis, deep coma, respiratory depression, and prescribed infrequently?

barbiturates

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

bradycardia.

The nurse is providing health education for a client who has been prescribed a benzodiazepine. What adverse effect should the nurse discuss in the teaching?

dependence

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

diazepam

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

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

increasing the effects of the neurotransmitter GABA.

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.

One week ago, a 74-year-old was started on a benzodiazepine 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?

paradoxical excitement

The nurse gives a 68-year-old client diphenhydramine to help the client sleep the night before surgery. At midnight, the nurse notes the client is awake and agitated. What pharmacologic principle would be the cause of this reaction?

paradoxical excitement, which is the opposite reaction than what was expected

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?

paradoxical reaction

A nurse is administering a prescribed dose of chlordiazepoxide to a client. The nurse should closely assess the client for what adverse reaction?

respiratory depression

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.