Chapter 13: Drugs Used for Sleep, Chapter 15: Drugs Used for Anxiety Disorders

In addition to facilitating sleep, what is another benefit of sedatives?

Decreased patient anxiety

Which is true regarding psychological drug dependence?

It requires medical intervention to treat

Which patient is most likely to respond quickly to antianxiety therapy with benzodiazepines?

Patient with recent anxiety reactions

Which two phases make up normal sleep?

Rapid eye movement(REM) and non REM

What instruction is most important for the nurse to teach the patient who has recently been prescribed alprazolam (Xanax)?

"You may feel dizzy or unsteady when rising to a standing position."

a nurse is reinforcing teaching a pt who has a new prescription for escitalopram for treatment of GAD. what statement shpws that the pt understands?

"i need to discontinue this med slowly"

What will the nurse caution a patient about when providing information about the prescribed azapirone antidepressant?

Risk of injury when using machinery

a nurse is caring for a pt who takes paroxetine to treat PTSD and says he grinds his teeth. the nurse should identify which of the following interventions to manage bruxism?

concurrent administration of buspirone,use of a mouth guard, and changing to a different class of antidepressant med.

The nurse is developing a teaching plan for patients prescribed buspirone (BuSpar). Which information about this medication should be included?

There is minimal potential for abuse

Which sleep pattern stage diminishes as an effect of aging?

Stage IV

A newly admitted psychiatric patient repetitively states, "I wish I were dead. I just want to kill myself." The priority nursing at this time is to:

provide for patient safety

The nurse is administering Somnote to a patient. When providing medication education to the patient, the nurse will include that Somnote should be:

taken with a full glass of water

Barbiturates have which common adverse effect(s)? (Select all that apply.)

ABDE a. Residual daytime sedation b. Headache d. Blurred vision e. Impaired coordination

Which substance(s) may increase the toxic effects of benzodiazepines? (Select all that apply.)

a. Alcohol b. Antihistamines c. Analgesics d. Sedatives f. Hypnotics

The nurse is assessing a patient prior to discharge from same day surgery following an incisional breast biopsy. When assessing the patient's central nervous system (CNS) function following sedative-hypnotic therapy, what will the nurse include? (Select all that apply.)

ABC a. Level of alertness b. Orientation c. Ability to perform motor functions

The prenatal nurse is educating a woman regarding preconception care. The patient informs the nurse that she is currently taking a benzodiazepine drug for management of anxiety. Appropriate teaching for this patient will include that benzodiazepines: (Select all that apply.)

AC readily cross into breast milk enter fetal circulation

The nurse transcribes an order for lorazepam for a patient experiencing nausea and vomiting as a result of alcohol withdrawal. The most appropriate route of administration for lorazepam with this patient would be:

. intramuscularly.

The nurse finds that a patient is extremely agitated, yells frequently, and is attempting to get out of bed without assistance. What is the nurse's initial action?

Spend uninterrupted time listening to the patient.

Which is the drug of choice to treat a patient with obsessive-compulsive disorder (OCD)?

Fluvoxamine (Luvox)

What is the recommended time over which antianxiety medications must be gradually tapered before discontinuation?

1 month

a nurse is teaching with a client who has OCD and a new prescription for paroxetine. which of the following instructions should the nurse include

it can take several weeks before you feel like the med is helping

The nurse is caring for an older patient recently admitted to an assisted living center who is experiencing insomnia associated with the recent relocation. At bedtime, which nursing action will assist the patient to sleep?

Performing back massage

For what conditions are benzodiazepines prescribed?

Preoperative sedation

The nurse is assessing a patient who is being evaluated in an outpatient clinic for complaints of back pain. The patient reports taking diphenhydramine for insomnia related to job stress. Which statement by the nurse is accurate regarding this medication?

"This medication should only be taken for 1 week."

a nurse is teaching a pt who has a new prescription for buspirone to treat anxiety. which of the following info would the nurse include?

"this med has low risk for dependency"

The nurse is explaining the use of medications to a patient with insomnia. Which statement about sedatives is true?

. Increased relaxation occurs with sedatives

A nurse is collecting data from a client who is suspected of having benzodiazepine toxicity. which of the following findings should the nurse identify as the priority?

hypotension

. Which assessment(s) would be included in the evaluation of a patient with anxiety? (Select all that apply.)

ABCDE a. Physical examination b. Psychological evaluation c. History of precipitation stressors d. Medication history e. Substance abuse history

What can occur as a result of rapid withdrawal from long-term use of barbiturate therapy? (Select all that apply.)

ABCD a. Anxiety b. Delirium c. Weakness d. Grand mal seizures

Which disease is associated with insufficient sleep?

Myocardial infarction

. Which is a benzodiazepine of choice when treating anxiety associated with alcohol withdrawal?

Oxazepam (Serax)

When reviewing a patient's history and physical information, the nurse notes that the patient has physician's orders for chloral hydrate and warfarin. During assessment of this patient, the nurse observes areas of petechiae and ecchymosis on the upper and lower extremities. The most appropriate lab work for the nurse to assess next is:

prothrombin time.

A female patient is admitted to the adult psychiatric floor with a diagnosis of generalized anxiety disorder. Anxiolytic medications and group therapy have been prescribed. Evaluation of therapeutic outcomes related to her acute stay can be measured by which assessment(s)? (Select all that apply.)

ABC a. She is able to sleep 5 hours during the night. b. The tremor and pacing she exhibited on admission are reduced. c. She is able to attend and actively participate in group sessions.

Why are benzodiazepines often preferred over barbiturates? (Select all that apply.)

ABCD a. They have selective action at specific receptor sites. b. There is a wide range of safety between therapeutic and lethal levels. c. REM sleep is decreased to a lesser extent. d. Accidental overdoses are well tolerated.

In addition to the relief of mild to moderate anxiety, hydroxyzine (Vistaril) has which additional therapeutic outcome(s)? (Select all that apply.)

ACD a. Reduced need for sedation and analgesia before and after surgery c. Control of itching in allergic reactions d. Control of vomiting

A patient has been prescribed lorazepam (Ativan), a benzodiazepine used to treat insomnia. Which action will the nurse take?

Assess the patient's blood pressure in sitting and lying positions

The nurse is preparing to educate a patient and significant other about antianxiety medications before the patient's discharge. What is pertinent information to be included in the teaching plan?

Discuss, review, and validate the behavior monitoring system and intervention flow sheet the patient and significant other will continue to use following discharge.

A patient receiving diazepam (Valium) is complaining of nausea and vomiting and is becoming jaundiced. Which type of blood work will be performed?

Liver function tests

An older adult patient received a hypnotic agent at 9:00 PM. At 2:00 AM, the nurse discovers that the patient has removed her gown and is attempting to get out of bed without assistance. What type of medication effect is the patient exhibiting?

Paradoxical

The outcome statement for a patient suffering from anxiety disorder reads, "After 1 week on alprazolam (Xanax) therapy, patient will exhibit a manageable level of anxiety." Which assessment finding validates that this outcome is met?

Patient reports sleeping better and increased interest in activities