CNS DEPEPRESSANTS UNIT 2 Flashcards

1
Q

What is a Benzodiazepine and what is it used for?

A

For sleep disorders and anxiety

hint*** PAMS AND LAMS

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2
Q

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

A. Lorazepam
B. Diazepam
C. Alprazolam
G. Midazolam

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3
Q

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

A. Drowsiness

SIDE EFFECTS/ ADVERSE EFFECTS OF BENZODIAZEPINES

Side effects/adverse reactions
 Lethargy, drowsiness, confusion, memory impairment
 Depression, tolerance and dependence
 Hypotension

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4
Q

What interactions should be avoided when a patient is already taking Benzodiazepines?

A. Vitamin B12
B. Alcohol and morphine
C. Metoprolol
D. Metformin

A

B. Alcohol and morphine

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5
Q

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

A

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

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6
Q

What should you assess for before giving an a patient a benzodiazepine?

A

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

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7
Q

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

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

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8
Q

What is insomnia? and who is mainly affected by it? What is the treatment for it?

A

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

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9
Q

What are great nursing interventions for a patient on BENZODIAZIPINES

A

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

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10
Q

What type of evaluation would you do to make sure the the therapeutic effect of the Benzodiazepine is effective?

A

-ask the patient if they’re anxiety went down
-ask the patient of they are having abetter time sleeping and easier time sleeping

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11
Q

Which of the following drugs is a Non-benzodiazepine?
A. Midazolam
B. Zolpidem
C. Metoprolol
D. Morphine

A

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

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12
Q

What is the following side effect of Zolpidem?
A. Hyperactive reflexes
B. Diarrhea
C. Memory impairment
D. kidney stones

A

C. Memory impairment

Side effects
Drowsiness, lethargy, dizzy, memory impairment

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13
Q

What is an Adverse Effect of Zolpidem?
A. Nightmares
B. Serotonin levels increased
C.Hypoglycemia
D. Hyperkalemia

A

A. Nightmares

Adverse Reactions
 Residual drowsiness (hangover)
 Vivid dreams, nightmares
 Drug dependence
 Drug tolerance
 Excessive depression
 Respiratory depression
 Hypersensitivity

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14
Q

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.

A

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.

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15
Q

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.

A

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.

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16
Q

Which drug is commonly used for
conscious sedation (Intravenous Anesthetic)?
A. Midazolam
B. Halothane
C. Isoflurane
D. Lidocaine

A

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

17
Q

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.

A

B. “Drink warm milk or chamomile tea before
bedtime.”

18
Q

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. A patient who has just suffered myocardial infarction

 Adverse effects of Midazolam
Respiratory and cardiovascular depression

19
Q

Where are Topical anesthetics administered?
A. Mucous Membranes
B. Intravenously
C. Otic
D. Opthamalic

A

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

20
Q

Which one of the following is an Local Anesthetic?
A. Fentanyl
B. Midazolam
C. Lidocaine
D. Acetominophen

A

C. Lidocaine

21
Q

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

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

22
Q

Is consciousness maintained when a patient has been given Lidocaine?
A. Yes
B. No

A

A. Yes

23
Q

Is the therapeutic effect of Lidocaine generalized , or localized?

A

Local

Block pain at the site where the drug is given

24
Q

Where are Local Anesthetics administered? Select all that Apply
A. Spinal
B. Cerebral
C. Cardiovascular
D. Pulmonary
E. Epidural

A

A. Spinal
E. Epidural

Local anesthetic injected in the spinal or
epidural space in the spine. Used commonly for
Cesarian sections

25
Q

Which of the following is a SIDE EFFECT of Local Anesthetics ?
A. Headache
B. Respiratory Depression
C. Hypotension
D. Decreased LOC

A

A. Headache

26
Q

Which of the following is a ADVERSE EFFECT of Local Anesthetics ?

A. Respiratory Depression
B. Increased LOC
C. Nightmares
D. Headache

A

A. Respiratory Depression

27
Q

Nursing CAUTION for Anestheics?

A

Assessment
Obtain a drug and health history, noting drugs that
affect the cardiopulmonary system
Reason for administration

28
Q

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.

A

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.

29
Q

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.

A

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.

30
Q

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.”

A

B. “Drink warm milk or chamomile tea before
bedtime.”

31
Q

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.

A

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.

32
Q

Which drug is commonly used for
conscious sedation?
A. Midazolam
B. Halothane
C. Isoflurane
D. Lidocaine

A

A. Midazolam

Midazolam (Versed) is commonly administered for
conscious sedation for minor surgery or procedures.