Phenobarbital Nursing Considerations Quiz
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Questions and Answers

What is the onset of action for oral phenobarbital?

  • 30 to 45 minutes
  • 45 to 60 minutes
  • Less than 30 minutes
  • Greater than 60 minutes (correct)

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

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

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

  • 30 to 60 hours
  • 180 to 240 hours
  • 60 to 180 hours (correct)
  • 10 to 20 hours

    • How does phenobarbital affect the CNS?

    <p>Depresses the CNS by inhibiting the conduction of impulses</p> Signup and view all the answers

    What type of seizures is phenobarbital used to treat?

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

    How is phenobarbital metabolized in the body?

    <p>Metabolized in the liver</p> Signup and view all the answers

    What is the duration of action for oral 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

    What is the intravenous (IV) form onset of action for phenobarbital?

    <p>5 minutes</p> Signup and view all the answers

    How is phenobarbital excreted from the body?

    <p>Excreted by the renal system</p> Signup and view all the answers

    What is the half-life of diazepam?

    <p>80 to 100 hours</p> Signup and view all the answers

    Where does diazepam primarily act?

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

    In which condition should the dosage of diazepam be reduced?

    <p>Patients with renal or hepatic impairment</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

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

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

    What are the contraindications for diazepam?

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

    What should be monitored during the administration of diazepam?

    <p>Vital signs and respiration</p> Signup and view all the answers

    What should be avoided during patient teaching for diazepam?

    <p>Alcohol and smoking avoidance</p> Signup and view all the answers

    What is an adverse effect of diazepam?

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

    In which patients should the dosage of diazepam be reduced?

    <p>Patients with critical illness</p> Signup and view all the answers

    What is a contraindication for phenobarbital use?

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

    In which patients is a lower dose of phenobarbital required?

    <p>Patients with hepatic impairment</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 administration route of phenobarbital may involve combining the medication with specific solutions?

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

    What is an adverse effect of phenobarbital use?

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

    Which drug interaction may increase the effects of phenobarbital?

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

    What should the nurse do when administering IV phenobarbital to avoid complications?

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

    What has the FDA issued a BLACK BOX WARNING for regarding phenobarbital?

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

    In which patient population is constant monitoring and early resuscitation recommended for parenteral administration of phenobarbital?

    <p>Critical illness patients</p> Signup and view all the answers

    What should patient teaching for phenobarbital include?

    <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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