Chapter 18 Flashcards
The patient is receiving anesthesia in preparation for surgery. The patient will be in which stage of anesthesia when the procedure occurs?
A) stage 1
B) stage 2
C) stage 3
D) stage 4
C) stage 3
Once the patient is anesthetized, the procedure will actually occur while the patient is in stage 3 of anesthesia.
A patient is admitted to the emergency department with an overdose of benzodiazepine. Which antidote will the nurse expect to administer?
A) flumazenil
B) naloxone
C) naltrexone
D) nalmefene
A) flumazenil
Flumazenil is the antidote for benzodiazepine overdoses. Naloxone, naltrexone, and nalmefene are used in opioid or narcotic overdose. Flumazenil should be used with caution when the patient is known to have an addiction to one of the benzodiazepine drugs because of the possibility of withdrawal seizures that may occur.
The patient is undergoing anesthesia in preparation for surgery. The patient is starting to have difficulty speaking and is losing the sensation of pain. Which anesthesia stage is the patient most likely experiencing?
A) stage 1
B) stage 2
C) stage 3
D) stage 4
A) stage 1
Difficulty speaking and loss of the sensation of pain both occur in stage 1 of anesthesia.
The patient is undergoing anesthesia in preparation for a procedure. The patient is experiencing hallucinations and dreams. Which anesthesia stage is the patient most likely experiencing?
A) stage 1
B) stage 2
C) stage 3
D) stage 4
A) stage 1
During stage 1 of anesthesia, the patient may experience dreams and both auditory and visual hallucinations.
During which phase of sleep do most recallable dreams occur?
A) stage 1 of nonrapid eye movement sleep (NREM)
B) stage 2 of nonrapid eye movement sleep (NREM)
C) during rapid eye movement (REM) sleep
D) throughout all phases of sleep
C) during rapid eye movement (REM) sleep
During REM sleep, individuals experience most of their recallable dreams.
The nurse is assessing a patient with a history of chronic sedative use. The nurse notes the patient is exhibiting muscle twitching, tremors, and dizziness, especially on moving from sitting to standing. Which reaction is the patient experiencing?
A) tolerance to the sedative
B) underdosing of the sedative
C) dependence to the sedative
D) an allergic response to the sedative
C) dependence to the sedative
Dependence is the result of chronic hypnotic use. Physical and psychological dependence can result. Physical dependence results in the appearance of specific withdrawal symptoms when a drug is discontinued after prolonged use. The severity of withdrawal symptoms depends on the drug and dosage. Symptoms may include muscular twitching and tremors, dizziness, orthostatic hypotension, delusions, hallucinations, delirium, and seizures.
The nurse is caring for a patient who is taking barbiturate. Which assessment finding requires immediate action by the nurse?
A) history of a sleep disorder
B) +1 pitting edema of the lower extremities
C) urinary output of 10 mL/h
D) blood pressure of 140/95 mm Hg
C) urinary output of 10 mL/h
The patient’s urinary output is insufficient and could result in toxicity. History of sleep disorder, +1 pitting edema, and a blood pressure of 140/95 do not require immediate intervention.
The patient has recently been prescribed a benzodiazepine and reports experiencing vivid dreams. What does this symptom indicate?
A) overdosage of the medication
B) allergic reaction to the medication
C) therapeutic effect of the medication
D) inadequate amount of the medication
C) therapeutic effect of the medication
The benzodiazepine medications are known to delay REM sleep and thus generate vivid dreams. Such a symptom is not indicative of overdosage, an allergic reaction, or inadequate dosage.
The patient has recently been prescribed a sedative-hypnotic medication and reports experiencing a “hangover”-type effect upon awakening. What does this symptom indicate?
A) a need to change to a different medication
B) toxicity level of the medication
C) allergic reaction to the medication
D) Inadequate amount of the medication
A) a need to change to a different medication
Some of the sedative-hypnotic drugs can produce a hangover-type effect; if this occurs, the patient should be changed to a different drug. Such a symptom is not indicative of overdosage, an allergic reaction, or inadequate dosage.
The patient is receiving triazolam as part of treatment for insomnia. The patient complains of experiencing memory problems. The nurse recognizes this as:
A) evidence of an allergic response
B) an idiosyncratic effect
C) an adverse reaction to the drug
D) evidence of drug toxicity
C) an adverse reaction to the drug
Memory issues may occur as an adverse reaction to triazolam.
Which nursing intervention would be most appropriate for a patient taking temazepam?
A) monitor for fever
B) give drug intravenously only
C) monitor daily weights
D) tell patient to ask for help before standing
D) tell patient to ask for help before standing
For safety, the patient should ask for help in getting up (especially an older adult who may have an unsteady gait) when taking a sedative-hypnotic. Temperature is usually not affected with temazepam; however, respiratory depression may occur. Temazepam is only given orally. Monitoring daily weight is not necessary, but renal impairment should be monitored.
What would indicate to the nurse that a patient taking a sedative-hypnotic requires more teaching?
A) the patient wants to listen to music on the radio
B) the patient has saved her urine to be measured
C) the patient says she has taken 1800 mL of fluid today
D) the patient requests a cup of kava kava tea to help her get to sleep faster
D) the patient requests a cup of kava kava tea to help her get to sleep faster
Kava kava is an herb that may interact with CNS depressants. Listening to music may promote sleep. Renal impairment should be monitored, and an adequate amount of liquid is necessary.
An older adult complains of insomnia. Which suggestion would be most appropriate for the nurse to provide as an initial method to deal with this issue?
A) “take Benadryl pills each evening before bedtime”
B) “drink warm milk or chamomile tea before bedtime”
C) “develop an exercise regimen for the evening hours”
D) “take naps during the day whenever you feel drowsy”
B) “drink warm milk or chamomile tea before bedtime”
Before medications are used, various nonpharmacologic methods should be used to promote sleep, including avoiding strenuous exercise before bedtime and avoiding naps during the day. Drinking warm milk or chamomile tea before bedtime has been found to promote sleep.
A patient is taking a hypnotic nightly to enhance sleep. The patient experiences vivid dreams and nightmares. This may be associated with:
A) hangover
B) tolerance
C) hypersensitivity
D) REM rebound
D) REM rebound
REM rebound, which results in vivid dreams and nightmares, frequently occurs after taking a hypnotic for a prolonged period and then abruptly stopping. A hangover is residual drowsiness resulting in impaired reaction time. Tolerance results when there is a need to increase the dosage over time to obtain the desired effect. Hypersensitivity is the development of skin rashes and urticaria (hives).
The most serious adverse effect of spinal anesthesia is:
A) hypotension
B) headache
C) respiratory distress
D) tachycardia
C) respiratory distress
Respiratory distress or failure is the most serious adverse effect of spinal anesthesia. (Remember: ABCs)
