PN 119 PrepU Chapter 21
The patient has Dalmane 15 mg PO at bedtime ordered. The drug comes in 30-mg tablets. How much should the nurse give this patient?
1/2 tablet
After administration of a hypnotic, a client complains of being unable to sleep. What is the nurse's best action?
Notify the health care provider.
The nurse assesses a respiratory rate of 10 breaths/minute in an adult client. Before administering a sedative, what is the nurse's best action?
Notify the health care provider.
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)
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
The nonbenzodiazepines have diminished hypnotic effects after how long? (Choose one)
14 days
What is the nurse's best action when administering zaleplon to a client?
Administer on an empty stomach.
A nursing student demonstrates understanding of the uses of sedatives and hypnotics when identifying acceptable uses as which of the following? (Select all that apply.)
insomnia convulsions seizures adjuncts for anesthesia
A client asks the nurse about continuing to drink one glass of red wine per day while also taking zolpidem (Ambien) for insomnia. What is the nurse's best response?
"Do not drink any alcoholic beverage two hours before taking the drug."
A nursing student indicates the need for further instruction on barbiturates when stating:
"I can give the patient in pain a barbiturate and this will help the patient sleep."
A woman who travels extensively for her job has been prescribed triazolam (Halcion) as a sleep aide. During patient teaching, what information should the nurse prioritize?
"If you stop taking this drug suddenly, you might find that your insomnia is worse than ever."
A nurse enters the patient's room to administer bedtime medications. The patient informs the nurse that he is not ready to go to sleep, but to leave the Lunesta with him and he will take it when he is ready to settle down. What would be the nurse's best response?
"Just ring the call bell when you are ready and I will bring it to you then."
A nursing assistant is seen carrying a bedtime snack of crackers and coffee into a client's room. The nurse is preparing to administer an oral dose of zaleplon (Sonata) to the client. What is the nurse's best action?
Advise the client that a snack may interfere with absorption of this medication.
A physician prescribes a total of 1.5 mg of estazolam to a patient. The available tablet of estazolam contains 1 mg of the drug. How many tablets of estazolam will the nurse have to administer to the patient at a time?
1.5 tablets
An adolescent has been prescribed a benzodiazepine for sleep disturbances after her parents divorced. What is the most important teaching point for the nurse to tell the client about this medication?
Discuss contraceptive methods if the client is sexually active.
The nurse enters a client's room at the beginning of a day shift and finds a medicine cup at the bedside containing one oral dose of zolpidem (Ambien). What should be the nurse's first action?
Ask the client why the medication was left at the bedside.
The nurse counts a respiratory rate of 8 breaths/minute for a client who received a sedative one hour ago. What is the nurse's priority action?
Assess level of consciousness.
The nursing student is learning in pharmacology class about sedatives and hypnotics. The student correctly identifies the two classes of sedatives as being which of the following? (Select both that apply.)
Barbiturates Nonbarbiturates
Examples of drugs that are specifically marketed for the treatment of insomnia include:
flurazepam, temazepam, and triazolam.
A nurse is caring for a patient who is prescribed barbiturates. Which effects of barbiturates should the nurse monitor the patient for? (Select all that apply.)
CNS depression Mood alteration Hypnosis
Secobarbital (Seconal) is classified in which pregnancy category? (Choose one)
Category D
Benzodiazepines are classified in which pregnancy category? (Choose one)
Category X
Before administering a barbiturate to a client, what is the nurse's priority action?
Check level of consciousness.
The nurse is caring for a client who has a sedative hypnotic ordered. The nurse should consider this drug contraindicated if the client had what disorder?
Liver failure
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 about to administer temazepam (Restoril) when the client informs the nurse that this medication has not been effective when taken in the past. What is nurse's best action?
Consult the health care provider.
A client in long term care regularly takes opioid analgesics for back pain relief. Recently, the client has been prescribed a low-dose hypnotic for insomnia. What is the nurse's first action before administering these medications?
Consult the primary health care provider.
The nurse should carefully assess for which top priority concern when administering a sedative or hypnotic?
Depressed respiratory function
An older adult client complains of insomnia while hospitalized. What are the best ways the nurse can help promote sleep? Select all that apply.
Dim hallway lights. Request a prescription for a sedative. Administer eszopiclone (Lunesta) per the prescribed dose.
An agent classified as a hypnotic is used primarily for preventing the feelings of tension or fear.
False
Which of the following is defined as a drug that induces drowsiness? (Choose one)
Hypnotic
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
The nurse should consider which assessment questions before administering a sedative or hypnotic? Select all that apply.
Is the client uncomfortable? Is it too early to give the drug? Are there any environmental disturbances? Has a consent form been signed? What are the client's baseline vital signs?
A nurse is caring for a patient with insomnia. The patient is prescribed a sedative. Which adverse reaction to sedatives is a gastrointestinal reaction?
Nausea
A nursing student studying sedatives and hypnotics in pharmacology class correctly states that they are best given for which of the following periods?
No more than 2 weeks
The nursing student has learned about a group of unrelated drugs that includes Lunesta and Ambien. This group is known as which of the following?
Nonbenzodiazepines
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?
Risk for injury
A client asks the nurse about the risks of taking melatonin for insomnia. What is the nurse's best response?
Synthetic forms from a reliable source carry decreased risk of contamination.
A 77-year-old patient is suffering from insomnia. Which of the following medications can be safely administered to this patient to induce sleep?
Temazepam (Restoril)
Which of these outcomes is most appropriate to establish for a client receiving a hypnotic medication before a minor procedure?
The client will remain relaxed and calm during the procedure.
If a pregnant patient has taken a benzodiazepine during pregnancy, what should be the biggest concern?
The infant may experience withdrawal symptoms during the postnatal period.
A pregnant patient with insomnia is administered a benzodiazepine. What is the possible effect of benzodiazepine on the health of the newborn child?
The newborn can develop withdrawal symptoms
The physician prescribing a drug for sleep will usually select a nonbarbiturate instead of a barbiturate. This is mainly due to which of the following reasons?
They have a lesser effect than barbiturates do on the respiratory rate.
The nurse is conducting an educational presentation on the use of drugs and herbal supplements. Which of the following herbal supplements is used mainly for its sedative-hypnotic properties?
Valerian
Which of the following herbal products has been used to improve overall sleep quality, shortening the length of time it takes to fall asleep, and decreasing the number of nighttime awakenings? (Choose one)
Valerian
An older adult client was administered a sedative at bedtime, which resulted in hyper-alertness and confusion. The client's son states he does not understand the term "paradoxical reaction." What is the nurse's best explanation for this term?
When a drug has the opposite effect of the usual intent
A nurse practitioner is ordering a new sedative for an elderly patient. What is an important consideration for this patient before the practitioner orders this type of drug?
age of the patient
A patient who has just had abdominal surgery 2 days ago reports not sleeping since the surgery. She states that her pain is constant and rates it between a 5 and 6 on a scale of 0 to 10. This patient should be given which type of drug in order to promote sleep?
analgesic
Nurses use complementary techniques to promote the effects of a sedative or hypnotic. Some things nurses can do to promote an optimal response to therapy are which of the following? (Select all that apply.)
back rubs quiet atmosphere night lights or darkened room
The patient who reports a headache and excessive drowsiness the morning after taking a hypnotic is experiencing which of the following complications?
drug hangover
Sedatives and hypnotics are used to primarily to treat:
insomnia.
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.
A nurse should not administer secobarbital to a patient with insomnia caused by:
pain.
A nurse knows that when elderly patients 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 nursing student correctly identifies the benzodiazepines as being which of the following class of drugs?
pregnancy category X
A patient informs the nurse that he has been taking an herb to help with mild anxiety. The patient says he has it in his tea every morning and it seems to help. He further states that it is GRAS (generally recognized as safe) for use in the United States. What is the name of this herb?
valerian
