Chapter 28: Book Qs & Evolve Flashcards
- With which drug for insomnia should you warn the patient about the side effect of sleepwalking, sleep-eating, or sleep-driving?
A. eszopiclone (Lunesta) B. flurazepam (Dalmane) C. cyclobenzaprine (Flexeril) D. chloral hydrate (Aquachloral)
A
- What should you instruct the patient to do immediately after taking a benzodiazepine receptor agonist?
A. Drink at least 8oz of water with the tablet or capsule. B. Go to bed within 5 to 10 minutes after taking the drug. C. Check your pulse for 1 full minute after taking the drug. D. Listen to soft and relaxing music to ensure adequate sleep.
B
- Which drugs belong to the benzodiazepine receptor agonist class? (Select all that apply.)
A. chloral hydrate (Somnote) B. estazolam (ProSom) C. eszopiclone (Lunesta) D. flurazepam (Dalmane) E. secobarbital (Seconal) F. triazolam (Halcion) G. zaleplon (Sonata) H. zolpidem (Ambien)
C G H
- Which drug for insomnia is rarely used now because it is a Schedule II drug with a high potential for abuse and dependence?
A. chloral hydrate (Aquachloral) B. flurazepam (Dalmane) C. pentobarbital (Nembutal) D. zolpidem (Ambien)
C
- Why should a patient taking a CNS depressant avoid drinking alcohol?
A. Alcohol can potentiate the sedating effect of these drugs. B. Alcohol reduces the pupil size increasing the risk for falls. C. Drinking alcohol with a CNS depressant lowers blood glucose levels. D. Combining a CNS depressant with alcohol increases the risk for urinary retention.
A
- What is the reversal agent for a benzodiazepine overdose? A. caffeine B. naloxone (Narcan) C. protamine sulfate D. flumazenil (Romazicon)
D
- Which statement made by a person prescribed to take zolpidem (Ambien) indicates a need for more teaching?
A. “I always go to bed as soon as I take this drug.” B. “I am so glad that this drug is so safe and has no potential for dependence.” C. “I will be sure to take this drug only when I have time to sleep for at least 4 hours.” D. “I will not drink alcoholic beverages or take any other sleep aid when I am taking this drug.”
B
The barbiturate drugs (pentobarbital and secobarbital) are rarely used for insomnia because they are classified as Schedule__ controlled substances with a high potential for _______.
II
abuse and addiction.
Do not give flumazenil (Romazicon) to anyone who has a _____ disorder.
seizure
To better monitor for side effects, assess the level of ________ before giving a drug for insomnia.
consciousness
A pediatric nurse knows that children receiving any sedating drug need to be watched for unusual or paradoxical responses. What is a paradoxical response?
One that doubles the expected result.
One that is half of what is expected.
One that takes three times as long to occur.
One that is opposite of what is expected.
One that is opposite of what is expected.
A paradoxical response is one that is opposite of what is expected. It is not one that doubles the expected result, or is half of what is expected, or takes three times as long to occur.
The prescriber just ordered eszopiclone (Lunesta) for a patient for insomnia. Before giving the drug, what is the most important assessment the nurse should do?
Ask what type of work the patient used to do.
Assess the patient’s present mental status.
Determine if anyone else in the family has insomnia.
Find out if the patient has any history of constipation.
Assess the patient’s present mental status.
The most important intervention for the nurse to do is to assess the patient’s current mental status. Also, ask the patient about usual sleep patterns and his or her specific difficulty with sleeping. In addition, ask about a history of depression, confusion, falls, and pain. Asking what type of work the patient does, or if anyone else in the family has insomnia, or if the patient has any history of constipation are not necessary things to determine before giving the medication for sleep.
A nurse is caring for a patient with a history of sleep deprivation. The nurse knows that an important outcome of sleep deprivation is related to what problem?
Psychotic disorders
Weight loss
Increase in immune function
Heightened risk for infection
Heightened risk for infection
Sleep deprivation increases the risk for infection and decreases and not increases immune function. It also has no relationship to psychotic disorders or weight loss.
The nurse is discharging a patient with a prescription for an insomnia medication. What statement about insomnia medications is true and should be included in patient teaching?
Side effects of insomnia drugs include tremors and diarrhea.
Insomnia medication can cause traveler’s amnesia.
Doubling insomnia medication will result in better sleep.
Do not take insomnia medications for longer than 2 to 4 months.
Insomnia medication can cause traveler’s amnesia.
Warn patients not to take these drugs on overnight airplane flights of less than 7 to 8 hours because they may experience transient memory loss called traveler’s amnesia. Remind them that the amnesia side effect can be reduced or avoided if they are able to get 4 or more hours of sleep after taking the drug. Tremors and diarrhea are side effects of drugs for narcolepsy. Insomnia medication should never be doubled. Insomnia medications should be taken only for short periods of time (2 to 4 weeks) and only when needed.
The nurse is discharging a patient with a new prescription for benzodiazepine receptor agonists. What is the most important instruction the nurse needs to give to the patient?
Have another person with you the first night you take the drug to see if sleepwalking will be a problem.
You should only drink one glass of wine or alcohol when taking this drug.
Make sure you have your kidney function checked because that is where these drugs are metabolized.
If one dose doesn’t work, then you can double the dose the next night.
Have another person with you the first night you take the drug to see if sleepwalking will be a problem.
Suggest to patients taking any of the benzodiazepine receptor agonists to have another person with them for the first night they take the drug to determine whether somnambulism (sleepwalking) will be a problem. Also stress the importance of not drinking alcohol while taking these drugs to avoid potentiating the sedating effects. Drugs for insomnia are metabolized by the liver and not kidney and then excreted by the kidney. When liver or kidney function is reduced, drug levels can become very high, with more side effects and adverse effects. Tell patients to take these drugs exactly as directed by the prescriber and never double the dose.
