Phenobarbital Nursing Considerations Quiz

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.

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.