Questions and Answers
Match the drug with its appropriate classification.
Diazepam = Benzodiazepine Zolpidem = Benzodiazepine-like Secobarbital = Barbiturate Ramelteon = Melatonin receptor agonist
Benzodiazepine-like drugs are used primarily for the treatment of which condition?
Insomnia
Which statements are accurate regarding benzodiazepines? (Select all that apply)
Which medication would the nurse anticipate will be prescribed for long-term use for sleep?
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For which concerning symptom does the nurse closely monitor in a patient taking a benzodiazepine?
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What nursing actions are appropriate for an older adult patient prescribed a sedative-hypnotic for insomnia?
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What should the nurse say to a patient who takes diazepam with grapefruit juice every morning?
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Which phrase describes the mechanism of action of benzodiazepines?
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Which patient statement about the pharmacodynamics of zolpidem requires further teaching by the nurse?
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Which patient statement about the pharmacodynamics of diazepam indicates effective medication teaching?
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Which assessment data would the nurse obtain before the administration of diazepam?
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Which assessment finding would cause the nurse to hold the dose of zolpidem and notify the health care provider?
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Which instructions would the nurse provide to a patient who has been prescribed diazepam? (Select all that apply)
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What effect should a patient who has been taking zolpidem for more than a year be educated to avoid sudden discontinuation of the drug?
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What drug interaction should a nurse discuss with a patient using St. John's wort and prescribed a benzodiazepine?
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Which patient, if prescribed a benzodiazepine, would the nurse contact the provider about?
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Study Notes
Drug Classifications
- Benzodiazepines: Include diazepam, known for their sedative-hypnotic properties.
- Benzodiazepine-like drugs: Primarily used to treat insomnia; an example is zolpidem.
- Barbiturates: Secobarbital falls under this category, used in an older context for sedation.
- Melatonin receptor agonists: Ramelteon is an example that helps regulate sleep-wake cycles.
Clinical Uses of Drugs
- Benzodiazepine-like drugs are primarily utilized in managing insomnia, providing a safer option for sleeplessness.
- Zolpidem is favored for long-term use in sleep disorders due to its efficacy and safety profile.
Characteristics of Benzodiazepines
- Highly addictive with potential to induce tolerance and dependence.
- They depress neuronal function across multiple central nervous system sites, leading to sedative, hypnotic, or stupor-inducing effects.
Nursing Considerations
- Monitor for respiratory depression in patients taking benzodiazepines.
- For older adults prescribed sedative-hypnotics, implementing safety measures like bed alarms and maintaining call lights and elevated side rails is crucial.
- Take caution with diazepam when combined with grapefruit juice, as it can enhance drug concentration and effects.
Pharmacodynamics Insights
- Benzodiazepines enhance GABA action, leading to depression across all CNS levels.
- Patients are educated on the transient nature of zolpidem in the system to alleviate concerns about prolonged effects.
- Effective medication teaching for diazepam involves understanding its sedative properties, advising against driving until patients are aware of their reactions.
Pre-Administration Assessment
- Evaluate blood pressure, respiratory rate, heart rate, mental status, and oxygen saturation before administering diazepam for a comprehensive safety check.
- A history of sleep apnea can warrant the withholding of zolpidem and the notification of the healthcare provider.
Patient Education
- Patients taking diazepam can crush tablets and mix with applesauce; it can be taken with or without food, and the concentrate should be diluted with water.
- Long-term zolpidem users should be counseled against sudden discontinuation to prevent withdrawal symptoms like vomiting.
- Patients on St. John's wort may experience reduced effectiveness of benzodiazepines, necessitating further discussion.
Special Considerations
- Contact the provider if a breastfeeding postpartum patient is prescribed a benzodiazepine, as safety for the infant requires careful consideration.
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Description
This quiz explores various drug classifications, including benzodiazepines, barbiturates, and melatonin receptor agonists. It also discusses their clinical uses, effects, and nursing considerations. Test your knowledge on the characteristics and implications of these medications.
