Chapter 20 PrepU
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
For which client should the nurse should notify the health care provider to clarify a prescription of lorazepam (Ativan)?
A client 67 years of age with acute narrow-angle glaucoma
A client is prescribed an anxiolytic agent. What would be most important for the nurse to include in the teaching?
"Be sure not to stop the drug abruptly."
A client has been prescribed alprazolam 0.5 mg PO t. i. d. for the treatment of anxiety. What statement by the client demonstrates an accurate understanding of the drug regimen?
"I will make sure not to stop the drug abruptly."
A patient's medication regimen for treatment of anxiety has been changed from a benzodiazepine to buspirone (BuSpar). The patient asks the nurse what makes this medication safer than the benzodiazepine he has taken. What is the nurse's best response?
"It will not produce sedation like benzodiazepines."
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 are examples of nonbenzodiazepine-type hypnotic and sedative drugs? (Select all that apply.)
-Eszopiclone (Lunesta) -Zolpidem (Ambien) -Zaleplon (Sonata)
Anxiolytic drugs can be used in the management of which conditions? (Select all that apply.)
-Seizures -Panic attacks -Alcohol withdrawal
A patient is having seizure activity and the physician has ordered diazepam (Valium) to be given parenterally. If this medication is administered intravenously, when will its onset of action be observed?
1-5 minutes
A client received lorazepam intravenously at 0900. The nurse should maintain the client on bedrest until approximately what time?
1200
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 who is receiving an intravenous barbiturate. What assessment should the nurse prioritize?
Blood pressure
A client with a high-pressure job temporarily requires an anxiolytic that has no sedative properties. What medication is most likely to meet this client's needs?
Buspirone
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 patient who is a school teacher and is concerned about feeling sedated at work?
Buspirone (BuSpar)
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
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 administers diazepam (Valium) to a client preoperatively for what purpose?
Decreased anxiety
A group of nursing students answers correctly if they identify which medication as the prototype benzodiazepine?
Diazepam (Valium)
An agent classified as a hypnotic is used primarily for preventing the feelings of tension or fear.
False
Barbiturates are considered the sedative and hypnotic drugs of choice.
False
A nurse is preparing to administer an anxiolytic to a client. What would be most appropriate for the nurse to do before administering the drug?
Have the client void.
Which action would be least appropriate for the nurse to do after administering an anxiolytic to a patient?
Having the patient walk to the bathroom
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 CNS depression
Medication reconciliation of an 82-year-old man who has recently moved to a long-term care facility reveals that the man takes 1 to 2 mg of lorazepam bid prn. The nurse should recognize what consequence of this aspect of the resident's drug regimen?
Increased risk for falls
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
A nurse is caring for a patient who is prescribed flurazepam. Which is an effect of flurazepam?
Induces sleep
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.
After teaching a patient who is receiving zolpidem, the patient demonstrates understanding of the information when the patient states that the drug should be taken:
Monitor the client for excessive or unusual effects (Test Error???) <---Its correct but does nog make sense...
After reviewing the various drugs that are classified as barbiturates, a student demonstrates understanding when identifying which as the prototype?
Phenobarbital
A patient undergoing treatment with barbiturates is showing symptoms of barbiturate toxicity. Which intervention should the nurse perform?
Provide respiratory assistance
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 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
A 70-year-old patient has just started taking lorazepam 10 days ago for anxiety issues related the death of her husband. She is staying with her daughter for a couple of weeks. The patient's daughter has noticed that her mother is having difficulty walking and seems to be confused at times and calls the clinic to report this to the nurse. The nurse will inform the daughter that:
a dose adjustment should be made if these symptoms persist.
A client is receiving a barbiturate intravenously. The nurse would monitor the client for:
bradycardia.
A 39-year-old patient who is having trouble sleeping is beginning drug treatment with zaleplon (Sonata). The nurse will be sure to ask if the patient is taking:
cimetidine (Zantac).
The prototype for benzodiazepines is:
diazepam.
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)
Patients taking benzodiazepines, especially elderly patients, are at high risk for:
falls.
A patient 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.
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 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.
