Phenobarbital Nursing Considerations Quiz
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Questions and Answers

What is the onset of action for oral phenobarbital?

  • 10 to 12 hours
  • Greater than 60 minutes (correct)
  • Within 1 hour
  • 5 minutes

    • How long does it take for phenobarbital to reach therapeutic serum levels?

  • 2 to 3 weeks (correct)
  • 1 week
  • 1 month
  • 5 days

    • What is the half-life of phenobarbital in children?

  • 60 to 180 hours (correct)
  • 30 to 60 hours
  • 20 to 40 hours
  • 10 to 20 hours

    • How does phenobarbital excrete from the body?

    <p>Renal system</p> Signup and view all the answers

    What is the primary action of phenobarbital?

    <p>Depresses the CNS</p> Signup and view all the answers

    For which type of seizures is phenobarbital used as a treatment?

    <p>Generalized tonic–clonic and partial seizures</p> Signup and view all the answers

    How does the IV form of phenobarbital act to control acute seizures?

    <p>Begins to act in 5 minutes and lasts approximately 6 hours</p> Signup and view all the answers

    What is the duration of the oral form of phenobarbital?

    <p>10 to 12 hours</p> Signup and view all the answers

    How long does it take for phenobarbital to reach a steady-state concentration?

    <p>3 weeks</p> Signup and view all the answers

    In what form is phenobarbital used to control acute seizures?

    <p>Parenteral form</p> Signup and view all the answers

    What is the half-life of diazepam?

    <p>20 to 80 hours</p> Signup and view all the answers

    On which system does diazepam primarily act?

    <p>Limbic system and reticular formation</p> Signup and view all the answers

    For which condition is IV diazepam used?

    <p>Severe recurrent convulsive seizures and status epilepticus</p> Signup and view all the answers

    In which patients should the dosage of diazepam be reduced?

    <p>Older adults and patients with renal or hepatic impairment</p> Signup and view all the answers

    What did the FDA issue a BLACK BOX WARNING for regarding diazepam?

    <p>Combination of benzodiazepines and opioids</p> Signup and view all the answers

    What are the contraindications for diazepam?

    <p>Acute narrow-angle glaucoma</p> Signup and view all the answers

    What is a key consideration for the administration of diazepam?

    <p>Avoiding certain administration methods</p> Signup and view all the answers

    What is included in patient teaching for diazepam?

    <p>Contraceptive use</p> Signup and view all the answers

    What are the adverse effects of diazepam?

    <p>CNS depression, paradoxical excitatory reactions, and cardiovascular collapse</p> Signup and view all the answers

    How does the half-life of diazepam vary in newborns and the elderly?

    <p>Longer in newborns and the elderly</p> Signup and view all the answers

    What is a contraindication to phenobarbital use?

    <p>Hypersensitivity to barbiturates</p> Signup and view all the answers

    Where should parenteral administration of phenobarbital in critical illness be done?

    <p>Critical care unit</p> Signup and view all the answers

    What is the most severe adverse effect of phenobarbital?

    <p>Stevens-Johnson syndrome</p> Signup and view all the answers

    What is the ultimate goal of therapy with phenobarbital?

    <p>Decrease seizure effects</p> Signup and view all the answers

    Which condition may require a lower dose of phenobarbital?

    <p>Hepatic impairment</p> Signup and view all the answers

    What is the FDA's warning regarding phenobarbital?

    <p>Risk of suicidal ideation and depression</p> Signup and view all the answers

    Which drugs interact with phenobarbital, increasing its effects?

    <p>Opioid analgesics</p> Signup and view all the answers

    How should IV phenobarbital be injected to avoid complications?

    <p>Into large veins at an infusion rate no faster than 60 mg/minute</p> Signup and view all the answers

    What should patients taking phenobarbital be monitored for?

    <p>Adverse effects such as paradoxical excitation</p> Signup and view all the answers

    What should be included in patient teaching for phenobarbital?

    <p>Guidelines for long-term administration</p> Signup and view all the answers

    Study Notes

    Phenobarbital Use and Nursing Implications

    • Older adults are at a higher risk for sedation and adverse drug reactions due to decreased absorption and altered renal excretion of phenobarbital.
    • Patients with decreased creatinine clearance may not be able to excrete phenobarbital adequately, while those with hepatic impairment require a lower dose to prevent adverse effects.
    • Parenteral administration of phenobarbital in critical illness should be done in a critical care unit for constant monitoring and early resuscitation in the event of respiratory arrest.
    • Adverse effects of phenobarbital include CNS depression, cognitive impairment, somnolence, agitation, confusion, vertigo, nightmares, and the most severe being Stevens-Johnson syndrome.
    • The FDA has issued a BLACK BOX WARNING for phenobarbital due to the risk of suicidal ideation and depression in patients taking the medication.
    • Contraindications to phenobarbital include known hypersensitivity to barbiturates, liver failure, nephritis, porphyria, respiratory depression, pregnancy, or addiction to barbiturates.
    • Several drugs interact with phenobarbital, increasing its effects, such as opioid analgesics, corticosteroids, doxycycline, estrogens, hormonal contraceptives, oral anticoagulants, and tricyclic antidepressants.
    • Oral administration of phenobarbital may occur without regard to food, while parenteral administration may involve combining the medication with specific solutions.
    • When administering IV phenobarbital, the nurse injects it into large veins at an infusion rate no faster than 60 mg/minute to avoid complications.
    • The ultimate goal of therapy with phenobarbital is to decrease seizure effects, assessed through the patient's EEG revealing decreased brain waves consistent with seizure activity.
    • The nurse assesses for adverse effects of phenobarbital, including increases in CNS activity consistent with paradoxical excitation, respiratory problems, changes in the integumentary system, and blood tests for toxicity and inadequate seizure treatment.
    • Patient teaching for phenobarbital includes guidelines for long-term administration, regular tests for serum levels, precautions for drowsiness, contraception for women of childbearing age, and notifying the prescriber about rashes or skin eruptions.

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    Description

    Test your knowledge of phenobarbital use and nursing implications with this quiz. Explore considerations for older adults, contraindications, adverse effects, drug interactions, administration guidelines, and patient teaching related to phenobarbital therapy.

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