CNS DEPEPRESSANTS UNIT 2 Flashcards
What is a Benzodiazepine and what is it used for?
For sleep disorders and anxiety
hint*** PAMS AND LAMS
What medications are listed under Benzodiazepines? SELECT ALL THAT APPLY
A. Lorazepam
B. Diazepam
C. Alprazolam
D. Zolpidem
E. Alluproniol
F. Acetominophen
G. Midazolam
A. Lorazepam
B. Diazepam
C. Alprazolam
G. Midazolam
Which of the following would be a side effect of Midazolam?
A. Drowsiness
B. Hyperactive Bowel Sounds
C. Diarrhea
D. Increased level of consciousness
A. Drowsiness
SIDE EFFECTS/ ADVERSE EFFECTS OF BENZODIAZEPINES
Side effects/adverse reactions
Lethargy, drowsiness, confusion, memory impairment
Depression, tolerance and dependence
Hypotension
What interactions should be avoided when a patient is already taking Benzodiazepines?
A. Vitamin B12
B. Alcohol and morphine
C. Metoprolol
D. Metformin
B. Alcohol and morphine
A patient has recently been admitted to to severe anxiety, nausea and respiratory depression. What medication wouldn’t you use and why?
A. Ondstetron can treat nausea
B.Lorazepam adverse effect can cause even greater respiratory depression
C. NS can cause fluid volume overload
D. Vitamin B 12 can increase the intrinsic factor
B.Lorazepam adverse effect can cause even greater respiratory depression
CONTRAINDICATIONS
-ALLERGY
-RESPIRATORY DEPRESSION
Caution
Older adults(LOW AND SLOW)
Depression, suicidal ideation
Severe liver and kidney problem
What should you assess for before giving an a patient a benzodiazepine?
Assessment
Determine whether the patient has a
history of insomnia or anxiety disorders.
Review drug history, medical history
Assess patient’s mental status
Vital signs
Which one of the following is a nonpharmalogical management of insomnia?
A. Intake of a glass of warm milk
B. listen to loud rock music
C. Drink alcohol 4 hours before bed
D. Take daytime naps
A. Intake of a glass of warm milk
Nonpharmacologic management of Sleep Disorders
Arise at specific hour in morning
Limit daytime naps
Avoid caffeine GREEN TEA HAS CAFFIENE, alcohol, and nicotine 6 hr before
bedtime
Avoid heavy meals, large amounts of fluids, loud
noise, and strenuous exercise before bedtime
Take warm bath, read, listen to quiet music, or drink
warm milk before bedtime
What is insomnia? and who is mainly affected by it? What is the treatment for it?
Insomnia is a common sleep disorder. With insomnia, you may have trouble falling asleep, staying asleep, or getting good quality sleep.
More common in female patients
Treatment: sedative-hypnotics
What are great nursing interventions for a patient on BENZODIAZIPINES
Nursing interventions
Monitor vital signs
Teach patient to use nonpharmacologic methods
to induce sleep.
Observe the patient for adverse reactions,
especially an older or debilitated patient.
Advise patients to report adverse reactions such
as respiratory depression, feelings of depression
Teach patient that these drugs should be
gradually withdrawn. Not to be stopped abruptly
What type of evaluation would you do to make sure the the therapeutic effect of the Benzodiazepine is effective?
-ask the patient if they’re anxiety went down
-ask the patient of they are having abetter time sleeping and easier time sleeping
Which of the following drugs is a Non-benzodiazepine?
A. Midazolam
B. Zolpidem
C. Metoprolol
D. Morphine
B. Zolpidem
Action
Neurotransmitter inhibition, CNS
depression
Duration of action is 6 to 8 hours
Use
Treat short-term (less than 10 days)
insomnia
Smaller doses in older adults
What is the following side effect of Zolpidem?
A. Hyperactive reflexes
B. Diarrhea
C. Memory impairment
D. kidney stones
C. Memory impairment
Side effects
Drowsiness, lethargy, dizzy, memory impairment
What is an Adverse Effect of Zolpidem?
A. Nightmares
B. Serotonin levels increased
C.Hypoglycemia
D. Hyperkalemia
A. Nightmares
Adverse Reactions
Residual drowsiness (hangover)
Vivid dreams, nightmares
Drug dependence
Drug tolerance
Excessive depression
Respiratory depression
Hypersensitivity
Which nursing intervention would be
most appropriate for a patient taking
lorazepam?
A. Monitor for fever.
B. Give drug intravenously only.
C. Monitor daily weights.
D. Tell patient to ask for help before standing.
D. Tell the 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.
Which drug is commonly used for
conscious sedation (Intravenous Anesthetic)?
A. Midazolam
B. Halothane
C. Isoflurane
D. Lidocaine
A. Midazolam
Midazolam (Versed) is commonly administered for
conscious sedation for minor surgery or procedures.
Induction and maintenance of anesthesia or
conscious sedation for minor surgery or
procedures
Patients are sedated and relaxed but
responsive to commands
Adverse effects
Respiratory and cardiovascular depression
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.”
What patient would you NOT administer Midazolam to?
A. A patient who has just suffered myocardial infarction
B. A patient with peptic ulcers
C. A patient with insomnia
D. A patient who has anxiety
A. A patient who has just suffered myocardial infarction
Adverse effects of Midazolam
Respiratory and cardiovascular depression
Where are Topical anesthetics administered?
A. Mucous Membranes
B. Intravenously
C. Otic
D. Opthamalic
A. Mucous Membranes
Topical anesthetics
Use
Mucous membranes, broken or unbroken skin
surfaces, and burns
Forms
Solution, liquid spray, ointment, cream, gel, and
powder
Decreases the sensitivity of nerve endings of
the affected area
Which one of the following is an Local Anesthetic?
A. Fentanyl
B. Midazolam
C. Lidocaine
D. Acetominophen
C. Lidocaine
What procedure in Lidocaine used for ? Select all that apply
A. Dental procedure
B. Open heart
C. Colonoscopy
D. Thoracic surgery
E. Cessarian Prodecure (C-SECTION)
A. Dental procedure
E. Cessarian Prodecure (C-SECTION)
Rapid onset, longer duration of action
Block pain at the site where the drug is given
Consciousness is maintained.
Use
Dental procedures, suturing skin lacerations
Short-term (minor) surgery at a localized area
Blocking nerve impulses (nerve block) below the insertion of a
spinal anesthetic
17
Is consciousness maintained when a patient has been given Lidocaine?
A. Yes
B. No
A. Yes
Is the therapeutic effect of Lidocaine generalized , or localized?
Local
Block pain at the site where the drug is given
Where are Local Anesthetics administered? Select all that Apply
A. Spinal
B. Cerebral
C. Cardiovascular
D. Pulmonary
E. Epidural
A. Spinal
E. Epidural
Local anesthetic injected in the spinal or
epidural space in the spine. Used commonly for
Cesarian sections
Which of the following is a SIDE EFFECT of Local Anesthetics ?
A. Headache
B. Respiratory Depression
C. Hypotension
D. Decreased LOC
A. Headache
Which of the following is a ADVERSE EFFECT of Local Anesthetics ?
A. Respiratory Depression
B. Increased LOC
C. Nightmares
D. Headache
A. Respiratory Depression
Nursing CAUTION for Anestheics?
Assessment
Obtain a drug and health history, noting drugs that
affect the cardiopulmonary system
Reason for administration
Which nursing intervention would be
most appropriate for a patient taking
lorazepam?
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.”
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.
Which drug is commonly used for
conscious sedation?
A. Midazolam
B. Halothane
C. Isoflurane
D. Lidocaine
A. Midazolam
Midazolam (Versed) is commonly administered for
conscious sedation for minor surgery or procedures.
