Sedative Drugs and Sleep Quiz

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Questions and Answers

What waves are characteristic of the first stage of sleep?

  • Delta waves
  • Alpha waves
  • Beta waves
  • Theta waves (correct)

Which sleep stage experiences the greatest reduction as individuals age?

  • Stage I
  • Stage IV (correct)
  • Stage III
  • Stage II

What should be monitored when a patient is prescribed lorazepam?

  • The patient's sleep duration
  • The patient's blood pressure in different positions (correct)
  • The patient's food intake
  • The patient's body temperature

What is the primary risk associated with insufficient sleep?

<p>Increase in risk of myocardial infarction (C)</p> Signup and view all the answers

Which type of brain waves are described as having the highest amplitude?

<p>Delta waves (B)</p> Signup and view all the answers

Which medication does not necessarily need to be taken with food?

<p>Lorazepam (D)</p> Signup and view all the answers

What is a common consequence of rapid discontinuation of lorazepam after prolonged use?

<p>Symptoms similar to alcohol withdrawal (A)</p> Signup and view all the answers

What percentage of normal sleep time does Stage II comprise?

<p>50% (B)</p> Signup and view all the answers

What is the risk associated with the long-term use of benzodiazepines?

<p>Habituation (A)</p> Signup and view all the answers

What laboratory tests should be conducted for a patient on diazepam presenting with nausea, vomiting, and jaundice?

<p>Liver function tests (D)</p> Signup and view all the answers

Which statement accurately reflects the effect of sedatives preoperatively?

<p>They help decrease patient anxiety. (D)</p> Signup and view all the answers

Which two phases constitute normal sleep?

<p>Rapid eye movement (REM) and non-REM (B)</p> Signup and view all the answers

Why are benzodiazepines not recommended for chronic insomnia treatment?

<p>They risk habituation. (A)</p> Signup and view all the answers

What adverse effects are specifically linked to the usage of benzodiazepines?

<p>Memory impairment (B)</p> Signup and view all the answers

What is an incorrect statement regarding the effects of sedatives?

<p>They increase postoperative pain control. (A)</p> Signup and view all the answers

What is a primary consideration in assessing a patient on benzodiazepines?

<p>Potential for drug habituation (C)</p> Signup and view all the answers

Which condition is not associated with a lack of sleep?

<p>Cancer (A), Glaucoma (B), Renal failure (D)</p> Signup and view all the answers

What nursing action can best assist an older patient with insomnia due to relocation?

<p>Performing back massage (C)</p> Signup and view all the answers

Which statement accurately describes the action of sedatives?

<p>Sedatives promote relaxation, not necessarily sleep. (A)</p> Signup and view all the answers

What is the purpose of performing a back massage for a patient experiencing insomnia?

<p>To promote relaxation and alleviate anxiety (C)</p> Signup and view all the answers

Which of the following is true regarding the effects of sedatives on sleep?

<p>They can lead to increased relaxation. (A)</p> Signup and view all the answers

A patient takes diphenhydramine for insomnia related to job stress. What should the nurse inform the patient?

<p>Diphenhydramine may cause drowsiness but is not a long-term solution for insomnia. (B)</p> Signup and view all the answers

What should patients avoid before bedtime to enhance sleep quality?

<p>Consuming caffeine products (B)</p> Signup and view all the answers

Which of the following is incorrect about the use of analgesics for insomnia?

<p>Analgesics are a recommended treatment for insomnia. (C)</p> Signup and view all the answers

What is a key reason benzodiazepines are often favored over barbiturates?

<p>They have selective action at specific receptor sites. (D)</p> Signup and view all the answers

Which of the following is an adverse effect commonly associated with barbiturates?

<p>Residual daytime sedation (C)</p> Signup and view all the answers

What symptom is least likely to occur with rapid withdrawal from benzodiazepine therapy?

<p>Enhanced focus (D)</p> Signup and view all the answers

Which statement regarding the safety of benzodiazepines compared to barbiturates is true?

<p>Benzodiazepines have a wider range of therapeutic dosages. (B)</p> Signup and view all the answers

Which symptom is typically NOT associated with barbiturate use?

<p>Hyperactivity (C)</p> Signup and view all the answers

Which of the following is a recognized effect of prolonged benzodiazepine use?

<p>Potential for overdose (B)</p> Signup and view all the answers

What should be monitored in patients undergoing withdrawal from long-term benzodiazepine therapy?

<p>Severe anxiety (C)</p> Signup and view all the answers

How do benzodiazepines affect REM sleep compared to barbiturates?

<p>Decrease REM sleep to a lesser extent. (D)</p> Signup and view all the answers

What is the most appropriate initial response by the nurse when encountering a patient exhibiting extreme agitation and attempting to leave bed without assistance?

<p>Spend uninterrupted time listening to the patient. (A)</p> Signup and view all the answers

Which of these is a paradoxical effect that might occur in older adult patients taking hypnotic agents?

<p>Episodes of confusion and restlessness. (B)</p> Signup and view all the answers

In which situation would the administration of benzodiazepines be indicated?

<p>Patient requiring sedation before a surgical procedure. (A)</p> Signup and view all the answers

What is the best practice for a nurse when sedating a patient experiencing high levels of anxiety?

<p>Engage the patient in a calming conversation first. (D)</p> Signup and view all the answers

What symptom would likely suggest a patient is experiencing a therapeutic effect of a hypnotic medication?

<p>Drowsiness leading to sleep. (B)</p> Signup and view all the answers

What should be monitored when a patient is taking chloral hydrate and warfarin?

<p>Prothrombin time (D)</p> Signup and view all the answers

What is a potential misconception of administering benzodiazepines for anxiety management?

<p>They are safe for long-term use without side effects. (A)</p> Signup and view all the answers

What is the primary role of a nurse when a patient is agitated and potentially needs medication?

<p>To assess the patient's anxiety and stressors. (C)</p> Signup and view all the answers

Why should diphenhydramine not be taken after a high-fat meal?

<p>There is no restriction on timing (A)</p> Signup and view all the answers

What is a potential side effect of taking diphenhydramine for insomnia?

<p>Developing a tolerance after lengthy use (A)</p> Signup and view all the answers

Which of the following describes a condition that does NOT indicate a need for benzodiazepines?

<p>Severe allergic reactions to medications. (C)</p> Signup and view all the answers

Which of the following statements regarding diphenhydramine is accurate?

<p>It has sedative properties. (D)</p> Signup and view all the answers

What should patients be aware of regarding the use of ramelteon?

<p>It should not be taken with a high-fat meal. (B)</p> Signup and view all the answers

In the context of patient education, how should chloral hydrate be viewed when taken with warfarin?

<p>It enhances the anticoagulant effects of warfarin. (A)</p> Signup and view all the answers

What common symptoms should be observed when a patient is on chloral hydrate and warfarin?

<p>Petechiae and ecchymosis (D)</p> Signup and view all the answers

What is the primary concern when a patient experiences tolerance to antihistamines like diphenhydramine?

<p>Ineffective sleep aid (D)</p> Signup and view all the answers

Flashcards

Alpha Waves

Brain waves present during relaxation, increased amplitude, and synchronization.

Stage I Sleep

The initial stage of sleep characterized by theta waves and light sleep.

Delta Waves

The slowest and highest amplitude brain waves occurring in stages 3 and 4 of sleep.

Aging and Stage IV Sleep

Stage IV sleep diminishes significantly with aging, often absent in people over 75 years.

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Lorazepam (Ativan) Use

Nurse should assess blood pressure in sitting and lying positions for patients on lorazepam.

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Insufficient Sleep Effects

Less than 5 hours of sleep per night increases the risk of myocardial infarction threefold.

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Sleep Stages Percentage

Stage II sleep comprises about 50% of normal sleep time while stages I and III are much less.

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Rapid Discontinuance of Benzodiazepines

Stopping lorazepam quickly may lead to withdrawal symptoms similar to alcohol withdrawal.

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Benzodiazepines versus Barbiturates

Benzodiazepines are preferred due to better safety margins and specific receptor actions.

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Therapeutic Window

The range between effective dose and lethal dose; wider for benzodiazepines.

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REM Sleep and Benzodiazepines

Benzodiazepines affect REM sleep less than barbiturates do.

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Adverse Effects of Barbiturates

Common effects include residual sedation, headaches, blurred vision, and impaired coordination.

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Residual Daytime Sedation

A common effect from long-acting barbiturates due to their long half-life.

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Withdrawal Symptoms of Benzodiazepines

Rapid withdrawal can lead to anxiety, delirium, weakness, and seizures.

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Insomnia in Older Adults

Difficulty sleeping, common with relocation stress in elderly.

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Paradoxical Response

An unusual reaction where a sedative causes excitement or hyperactivity.

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Impaired Coordination

Loss of motor control; a common adverse effect of barbiturates.

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Effective Nursing Action for Insomnia

Giving a back massage promotes relaxation and relieves anxiety.

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Caffeine and Sleep

Caffeine-containing products can interfere with sleep.

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Definition of Sedatives

Drugs that quiet the patient and promote relaxation, not necessarily sleep.

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Sedatives vs. Hypnotics

Sedatives promote relaxation; hypnotics induce sleep.

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Sedatives and REM Sleep

Sedatives do not increase total REM sleep time.

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Diphenhydramine Usage

Diphenhydramine is an antihistamine often used for insomnia relief.

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Patient Education on Medications

Educating about drug effects is crucial for patient safety.

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Duration of medication use

Some medications should only be taken for 1 week.

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Nausea from medications

Diphenhydramine does not cause nausea when used as directed.

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High-fat meal restrictions

Diphenhydramine can be taken without restriction after high-fat meals.

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Nature of diphenhydramine

Diphenhydramine is not an herbal medication.

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Chloral hydrate effect

Chloral hydrate can enhance the effects of warfarin.

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Signs of bleeding

Look for petechiae and ecchymosis in patients on anticoagulants.

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Monitoring prothrombin time

Monitor prothrombin time in patients using warfarin.

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Ramelteon usage

Ramelteon should not be taken with a high-fat meal.

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Benzodiazepines

Commonly prescribed medications that can cause habituation if used long-term.

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Hepatotoxicity indicators

Nausea, vomiting, and jaundice may signal liver damage.

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Liver function tests

Blood tests that assess the liver's health and detect damage.

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Sedatives

Medications that help reduce anxiety and facilitate calmness before surgery.

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Normal sleep phases

Sleep consists of two main phases: REM and non-REM sleep.

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Hypnagogic state

The transitional phase from wakefulness to sleep.

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Hypnopompic state

The transitional phase from sleep to wakefulness.

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Benzodiazepine effects

These medications do not have an antipsychotic effect.

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Initial Action for Agitated Patient

The first action is to listen to the patient to assess their anxiety levels.

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Paradoxical Effect in Older Adults

An unexpected reaction such as excitement or confusion after taking a sedative.

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Benzodiazepines Purpose

They are prescribed for their sedative-hypnotic effect, especially for preoperative sedation.

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Therapeutic Effect of Hypnotics

The intended effect of a hypnotic is to induce sedation and promote sleep.

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Assessing Anxiety in Nursing

It's crucial to assess a patient's anxiety before administering medications.

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Chronic Insomnia

A condition often treated with medications like benzodiazepines.

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Sedative-Hypnotic Agents

Medications that induce sedation or promote sleep, such as benzodiazepines.

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Clinical Judgment in Nursing

The nurse's ability to assess and respond appropriately to patient needs.

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Study Notes

Multiple Choice Questions on Sedative Drugs

  • Question 1: A patient is extremely agitated and trying to get out of bed. The initial nurse action is to listen to the patient's stressors.
  • Question 1 Answer: Spend uninterrupted time listening to the patient.
  • Question 2: An older adult patient takes a hypnotic medication at 9:00 PM and is now attempting to get out of bed at 2:00AM without assistance. What is the patient exhibiting?
  • Question 2 Answer: Paradoxical effect.
  • Question 3: Which condition requires benzodiazepines?
  • Question 3 Answer: Pre-operative sedation.
  • Question 5: What is a benefit of using sedatives?
  • Question 5 Answer: Decreased patient anxiety.

Sleep Stages and Aging

  • Question 7: Which sleep stage diminishes with age?
  • Question 7 Answer: Stage IV.

Lorazepam (Ativan) Dosage and Administration

  • Question 8: How should the nurse administer Lorazepam?
  • Question 8 Answer: Assess patient's blood pressure in sitting and lying positions prior to drug administration. Do not instruct the patient to discontinue the medication once sleep improves, The patient should not lie down before taking the medication.

Sedatives and Liver Function

  • Question 13 A patient is taking chloral hydrate and warfarin, and presents with ecchymosis. Which lab test should the nurse order?
  • Question 13 Answer: Prothrombin time.
  • Question 14: How should a patient take Ramelteon?
  • Question 14 Answer: Should not be taken with a high fat meal.

Benzodiazepines vs Barbiturates

  • Question 1: Why are benzodiazepines sometimes preferred over barbiturates?
  • Question 1 Answer: Selective action at specific receptor sites, a wider safety margin between therapeutic and lethal doses, less reduction in REM sleep, and better tolerance in accidental overdoses.

Barbiturates Adverse Effects

  • Question 2: What are common adverse effects of barbiturates?
  • Question 2 Answer: Residual daytime sedation, headache, blurred vision, and impaired coordination.

Benzodiazepine Withdrawal

  • Question 3: What effects can occur with rapid withdrawal from long-term benzodiazepine use?
  • Question 3 Answer: Anxiety, delirium, weakness, and grand mal seizures.

CNS Function and Sedatives

  • Question 4: What information is needed to assess CNS function following sedative/hypnotic therapy?
  • Question 4 Answer: Level of alertness, orientation, ability to perform motor functions, and usual sleep pattern.

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