A patient taking an anxiolytic reports feeling drowsy and unsteady.
What should the nurse advise the patient to do while on this medication? Select all that apply.

Choice A rationale

While blood pressure is an important vital sign, it is not the primary assessment before administering a hypnotic medication unless the medication has a known and significant effect on blood pressure, such as causing hypotension. Assessing for current or recent blood pressure is not the most crucial factor compared to the patient's history of substance abuse, given the nature of these medications.

Choice B rationale

Recent blood glucose levels are not a primary concern for most hypnotic medications unless the patient has a history of diabetes or the medication is known to affect glucose metabolism. This assessment would be more relevant for medications like corticosteroids or certain antipsychotics, but it is not a routine or critical pre-administration assessment for hypnotics.

Choice C rationale

A patient's dietary intake is generally not the most critical assessment before administering a hypnotic medication, although some foods or beverages, like caffeine, can interfere with sleep. The primary concerns are the patient's history of substance use, other medications, and potential contraindications related to central nervous system depression.

Choice D rationale

Hypnotic medications, which are central nervous system depressants, have a high potential for abuse and dependence. A history of substance abuse, including alcohol or other sedatives, significantly increases the risk of addiction, tolerance, and withdrawal symptoms. Therefore, assessing this history is a crucial step to ensure patient safety and prevent misuse or overdose.

Choice A rationale

Kava, despite being a natural product, is not safe for everyone. It has been associated with a significant risk of severe liver damage, including hepatitis, cirrhosis, and liver failure, even with moderate use. The active compounds, kavalactones, are metabolized by the liver and can cause hepatotoxicity, making it unsafe for individuals with pre-existing liver disease.

Choice B rationale

Kava is not a prescription medication in the United States or many other countries. It is widely available over-the-counter as a dietary supplement in various forms, such as capsules, powders, and teas. Its status as a supplement, rather than a drug, means it is not subject to the same strict regulations and oversight as prescription medications.

Choice C rationale

While some studies have explored kava's anxiolytic properties, it is not recommended for patients with depression. There is no strong evidence to support its use for this condition, and the potential for liver toxicity makes it a high-risk supplement. The risk of liver damage outweighs any potential benefit, especially given the availability of safer, effective antidepressant treatments.

Choice D rationale

The most appropriate response is to advise the patient to inform their healthcare provider. Kava can interact with many medications, particularly those metabolized by the liver, such as sedatives, anxiolytics, and antidepressants, increasing the risk of both drug toxicity and liver damage. A healthcare provider can assess for potential harmful interactions and advise on safe use.