Pharm CNS - Depressants (ch 12)

A nurse is providing instructions to a female client who has a new prescription for zolpidem. Which of the following instructions should the nurse include? a. "Notify the provider if you become pregnant." b. "Take the medication 1 hr before you plan to go to sleep." c. "Allow at least 6 hr for sleep when taking zolpidem." d. "To increase the effectiveness of zolpidem, take it with a bedtime snack."

a. "Notify the provider if you become pregnant." ATI

An intravenous dose of midazolam (Versed) has been prescribed for a patient before a colonoscopy. The nurse informs the patient that one of the most common adverse effects of this medication is what effect? a. Amnesia b. Dry mouth c. Chest pain d. Constipation

a. Amnesia Pharm

The nurse will monitor the patient who is taking a muscle-relaxant for which adverse effect? a. CNS depression b. hypertension c. peripheral edema d. blurred vision

a. CNS depression Pharm

A pt will be receiving the barbiturate phenobarbital as part of treatment for seizures. Which medications are known to cause interactions with barbiturates? (Select all that apply) a. benzodiazepines b. proton pump inhibitors c. oral contraceptives d. anticoagulants e. monoamine oxidase inhibitors (MAOIs)

a. benzodiazepines c. oral contraceptives d. anticoagulants e. monoamine oxidase inhibitors (MAOIs) workbook

The nurse is preparing to administer a medication for sleep. Which intervention applies to the administration of a non-benzodiazepine, such as zaleplon (Sonata?) a. these drugs need to be taken about 1 hr before bedtime b. because of their rapid onset, these drugs need to be taken just before bedtime c. the pt needs to be cautioned about the high incidence of morning drowsiness that may occur after taking these drugs d. these drugs are less likely to interact with alcohol

b. because of their rapid onset, these drugs need to be taken just before bedtime Pharm

phenobarbital: drug class and indications

barbiturate -seizure prophylaxis

A patient is admitted to the emergency department after taking an overdose of a barbiturate 15 minutes before arrival. The nurse can anticipate that which drug will be prescribed? a. Ipecac syrup b. Naloxone (Narcan) c. Flumazenil (Romazicon) d. Charcoal (Activated charcoal)

d. Charcoal (Activated charcoal) Pharm

Which nursing diagnosis is appropriate for a patient who has just been administered a sedative-hypnotic drug? a. Risk for infection b. Deficient knowledge c. Imbalanced nutrition d. Risk for injury and falls

d. Risk for injury and falls Pharm

benzodiazepine antidote

flumazenil

indications for diazepam (5)

trade name: Valium -anxiety -seizure disorders -muscle spasm -alcohol withdrawal -preoperative sedation/anesthesia adjunct

barbiturate interactions (9)

-alcohol -antihistamines -benzodiazepines -opioids -tranquilizers -MAOIs -anticoagulants -glucocorticoids -oral contraceptives

benzodiazepine drug interactions (4)

-alcohol -barbiturates -opioids -muscle relaxants

indications for barbiturates (2)

-anesthesia -seizures, convulsions

indications for benzodiazepines (6)

-anxiety disorders -seizure disorders -insomnia -muscle spasm -alcohol withdrawal (diazepam, chlordiazepoxide) -preoperative sedation

barbiturate adverse effects (5)

-deprive people of REM sleep -drowsiness -lethargy -hangover -paradoxical restlessness or excitement

barbiturate suffix

-ital (ex: phenobarbital)

sedatives vs hypnotics

-sedatives are drugs that reduce nervousness, excitability, and irritability without causing sleep -hypnotics cause sleep

benzodiazepine suffixes (2)

-zepam (ex: lorazepam) -zolam (ex: midazolam)

sedative-hypnotics: 3 main classes

1. barbiturates 2. benzodiazepines 3. misc. drugs (benzodiazepine-like meds)

In which time frame should the nurse expect the greatest risk for hypotension after administration of muscle relaxants? a. 10 min after administration b. 60 min after administration c. 2 hrs after administration d. 4 hrs after administration

b. 60 min after administration workbook

A nurse is providing instructions for a client who has been experiencing insomnia and has a new prescription for temazepam. The nurse should inform the client that which of the following manifestations are adverse effects of temazepam? Select all that apply: a. incoordination b. hypertension c. pruritus d. sleep driving e. amnesia

a. incoordination d. sleep driving e. amnesia (trade name is Restoril, used for insomnia) ATI

When reviewing actions of drugs, the nurse recognizes that a hypnotic is a drug that performs which action? a. produces sleep b. stops seizures c. prevents nausea and vomiting d. relieves pain

a. produces sleep workbook

A pt will be undergoing a brief surgical procedure to obtain a biopsy from a superficial mass on his arm. The nurse expects that which type of barbiturate will be used at this time? a. ultrashort b. short c. intermediate d. long

a. ultrashort workbook

A nurse is teaching about zolpidem with a client who has insomnia. The nurse should identify that which of the following client statements indicates an understanding of the teaching? a. "I will need to get a laboratory test prior to a refill of this medication." b. "I will use this medication for a short period of time." c. "I will need to take this medication for 1 week before results are seen." d. "I will need to change the medications to prevent building up a tolerance."

b. "I will use this medication for a short period of time." ATI

pentobarbital: drug class and indications

barbiturate -preoperative sedation -control convulsive conditions

The nurse should monitor an older adult patient prescribed a benzodiazepine for treatment of insomnia for which potential adverse effect? a. Red rash b. Unsteady gait c. Muscle spasms d. Shortness of breath

b. Unsteady gait Pharm

A patient is admitted to the hospital with a diagnosis of benzodiazepine overdose. He is very drowsy but still responsive. The nurse will prepare for which immediate intervention? a. hemodialysis to remove the medication b. administration of flumazenil c. administration of naloxone d. intubation and mechanical ventilation

b. administration of flumazenil Pharm

Which drug represents the only drug that acts directly on skeletal muscle? a. diazepam (Valium) b. dantrolene (Dantrium) c. baclofen (Lioresal) d. methocarbamol (Robaxin)

b. dantrolene (Dantrium) workbook

The nurse is providing care for a pt who has accidentally taken an overdose of benzodiazepines. Which drug would be used to treat this pt? a. methamphetamine b. flumazenil c. epinephrine d. naloxone

b. flumazenil workbook

A nurse is teaching a client who has a new prescription for ramelteon. The nurse should instruct the client to avoid which of the following foods while taking this medication? a. baked potato b. fried chicken c. whole-grain bread d. citrus fruits

b. fried chicken (high-fat foods prolong the absorption of ramelteon and should be avoided) ATI

A pt who has been taking a benzodiazepine for 5 weeks has been instructed to stop the medication. Which instruction will the nurse provide to the pt on how to discontinue the medication? a. stop taking the drug immediately b. plan a gradual reduction in dosage c. overlap this medication with another drug d. take the medication every other day for a number of weeks

b. plan a gradual reduction in dosage workbook

During patient teaching, the nurse explains the difference between a sedative and hypnotic with which statement? a. "There really is no difference; the terms are used interchangeably." b. "Whereas sedative drugs induce sleep, hypnotic drugs induce a state of hypnosis." c. "Most drugs produce sedation at low doses and sleep, the hypnotic effect, at higher doses." d. "Sedatives are much stronger than hypnotic drugs and should only be used for short periods of time."

c. "Most drugs produce sedation at low doses and sleep, the hypnotic effect, at higher doses." Pharm

The nurse is reviewing the prescriptions for a pt who will be discharged to home after being hospitalized for a hysterectomy. The pt asks for a sleeping pill, and the surgeon wrote a prescription for Ambien, 10 mg at bedtime as needed for sleep. What is the nurse's priority action at this time? a. review the potential adverse effects with the pt b. suggest that the pt try drinking a glass of wine at bedtime c. contact the prescriber to question the dose of the Ambien d. assist the pt to find a pharmacy to fill the prescription on her way home

c. contact the prescriber to question the dose of the Ambien (5 mg is the maximum dose for women) Pharm

A nurse is caring for a client who is receiving moderate sedation with diazepam IV. The client is oversedated. Which of the following medications should the nurse anticipate administering to this client? a. ketamine b. naltrexone c. flumazenil d. fluvoxamine

c. flumazenil ATI

An older adult has been given a benzodiazepine for sleep induction, but the night nurse noted that the pt was awake most of the night, watching television and reading in bed. The nurse documents that the pt has had which type of reaction to the medication? a. allergic b. teratogenic c. paradoxical d. idiopathic

c. paradoxical Pharm

A patient with back muscle spasms is being treated with a skeletal muscle relaxant. To ensure that these drugs are most effective, the nurse will make sure what other treatment is ordered? a. benzodiazepines b. moist heat c. physical therapy d. aspirin

c. physical therapy workbook

Which considerations are important for the nurse to remember when administering a benzodiazepine as a sedative-hypnotic drug? (Select all that apply) a. these drugs are intended for long-term management of insomnia b. these drugs can be administered safely with other CNS depressants for insomnia c. the dose needs to be given about 1 hr before the pt's bedtime d. the drug is used as a first choice treatment for sleeplessness e. the pt needs to be evaluated for the drowsiness that may occur in the morning after a benzodiazepine is taken

c. the dose needs to be given about 1 hr before the pt's bedtime e. the pt needs to be evaluated for the drowsiness that may occur in the morning after a benzodiazepine is taken Pharm

The health care provider prescribes dantrolene (Dantrium) to a patient immediately after surgery. What condition does the nurse expect the patient has experienced? a. Delirium tremens b. Respiratory arrest c. Tonic-clonic seizure d. Malignant hyperthermia

d. Malignant hyperthermia (dantrolene is a muscle relaxant used for the management of skeletal muscle spasms that accompany malignant hyperthermia) Pharm

A hospitalized pt is complaining of having difficulty sleeping. Which action will the nurse take first to address this problem? a. administer a sedative-hypnotic drug if ordered b. offer tea made with the herbal preparation valerian c. encourage the pt to exercise by walking up and down the halls a few more times if tolerated d. provide an environment that is restful, and reduce loud noises

d. provide an environment that is restful, and reduce loud noises Pharm

While monitoring a patient who took an overdose of barbiturates, the nurse keeps in mind that the cause of death would be which of these? a. tachycardia b. hypertension c. dyspnea d. respiratory arrest

d. respiratory arrest workbook

The nurse is caring for a client who is about to undergo a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of ketamine as an intravenous anesthetic? a. peptic ulcer disease b. breast cancer c. diabetes mellitus d. schizophrenia

d. schizophrenia (ketamine can produce psychological effects, such as hallucinations) ATI

indications for midazolam (2)

trade name: Versed -preoperative sedation -moderate sedation