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Drugs Used for Sedation and Sleep > Pharmacology
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Total Questions : 16
Showing 16 questions, Sign in for moreEducation given to clients about the use of all drugs to treat insomnia should include an emphasis on what important issue?
A patient is to receive conscious sedation for a minor surgical procedure. Which drug administration should the nurse expect? Select all that apply
A patient has been admitted to the emergency department because of an overdose of an oral benzodiazepine. He is very drowsy but still responsive. The nurse will prepare for which immediate intervention?
An older adult has been given a benzodiazepine for sleep induction, but the night nurse noted that the patient was awake most of the night, watching television and reading in bed. The nurse documents that the patient has had which type of reaction to the medication?
Which considerations are important for the nurse to remember when administering a benzodiazepine as a sedative-hypnotic drug? Select all that apply
A patient is to receive diazepam 4 mg IV push as a “now” order for sedation. The medication is available for injection with a concentration of 5 mg/mL. How many milliliters will the nurse give for this dosage?
Explanation
A patient has been prescribed diazepam 4 mg IV push for sedation. To administer this safely, the nurse must calculate the correct volume of the medication. Accurate dosage calculation is essential in IV therapy to ensure therapeutic effectiveness while preventing potential overdose or adverse effects.
Rationale for correct answer:
The problem requires determining the volume (in milliliters) of a medication solution needed to deliver a specific dose, given its concentration.
1. Identify the Known Values
- Desired Dose (D): 4mg
- Available Concentration (H): 5mg per 1mL
- Available Amount (A): 5mg
- Volume to Administer (V): 1mL
2. Use the Dosage Calculation Formula
The most common formula for this type of calculation is:
Volumetogive=AvailableAmount(H)DesiredDose(D)​×Volume(V)
3. Substitute the Values into the Formula
Volumetogive=5mg4mg​×1mL
4. Perform the Calculation
Volumetogive=0.8×1mL
Volumetogive=0.8mL
= The nurse will give 0.8mL of the diazepam injection.
Take-home points:
- Always use the formula: Volume to give = (Desired Dose ÷ Available Dose) × Volume, when calculating IV medication volumes.
- Verify the concentration of the solution before performing calculations to avoid medication errors.
- Administer exactly the calculated volume (in this case, 0.8 mL) to ensure safe and effective sedation.
The nurse is reviewing the prescriptions for a patient who will be discharged to home after being hospitalized for a hysterectomy. The patient asked 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 patient who has been receiving benzodiazepines for several years was told by the nurse that this may cause which condition as a complication?
The nurse is making rounds at 2 am on the unit during the night shift and notes that one of the older patients is awake. The nurse reviews the patient’s bedtime medication and sees that 5 mg of zolpidem (Ambien) was administered at 9 pm. What interventions are appropriate for the nurse to do next? Select all that apply
The nurse was discussing the difference between temazepam (Restoril) and zolpidem (Ambien) with a patient requesting drug therapy for sleep disturbance. Which of the following statements are appropriate? Select all that apply
The nurse taking care of a patient who was admitted for an overdose of lorazepam (Ativan) knows which antidote will be used?
The nurse is monitoring laboratory results for a patient who has been taking quazepam (Doral) for several years. The following laboratory values on the patient’s chart are considered elevated; indicate with an X the ones that would alert the nurse to possible hepatotoxicity or blood dyscrasias.
Explanation
The nurse is monitoring a patient who has been taking quazepam (Doral), a long-acting benzodiazepine, for several years. Chronic use of certain medications can sometimes contribute to hepatotoxicity or blood dyscrasias. Careful monitoring of laboratory values helps identify the early signs of liver injury or hematologic complications. This allows prompt nursing interventions to prevent serious adverse effects.
Rationale for correct answers:
- AST (aspartate aminotransferase): Elevated AST is a marker of hepatocellular injury. Long-term use of medications metabolized by the liver, including quazepam, can increase AST levels, indicating potential liver toxicity.
- ALP (alkaline phosphatase): Elevated ALP may indicate cholestasis or liver dysfunction, which can occur with prolonged drug therapy. Monitoring this value helps detect liver injury early.
- ALT (alanine aminotransferase): ALT is another sensitive marker of hepatocellular damage. Persistent elevations suggest hepatotoxicity, requiring evaluation of medication effects on liver function.
- Platelets: A low platelet count indicates thrombocytopenia, which is a type of blood dyscrasia. Long-term medication use may suppress bone marrow, so monitoring is important.
- WBC (white blood cells): Abnormal WBC levels suggest leukopenia or other hematologic issues, which can result from drug-induced bone marrow suppression. Monitoring helps prevent infection risk.
- PT/INR (prothrombin time/international normalized ratio): Prolonged PT/INR reflects impaired liver synthesis of clotting factors, which can result from hepatotoxicity. This value is critical for assessing liver function. Clinically, this also represents a blood dyscrasia, because the patient becomes predisposed to excessive bleeding or hemorrhage even from minor injuries or invasive procedures.
Take-home points:
- Regular monitoring of liver function tests is essential for patients on long-term benzodiazepines.
- Monitor hematologic parameters to detect blood dyscrasias early.
- Early identification of abnormal lab values allows timely intervention, such as adjusting or discontinuing the medication, to prevent serious complications.
It is important for the nurse teaching the patient regarding secobarbital (Seconal) to include which information about the drug?
A patient received spinal anesthesia. Which is most important for the nurse to monitor?
The nurse will monitor the patient who is taking a muscle relaxant for which adverse effect?
A client is admitted to undergo a surgical procedure. The nurse should be aware that which of the following preexisting conditions may be a contraindication for the use of ketamine (Ketalar) as an intravenous anesthetic for this client?
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