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29 Cards in this Set

  • Front
  • Back
Name 3 groups of sedative/hypnotics?
barbiturates
benzodiazepines
miscellaneous
Name 1 barbituate?
phenobarbital
Name 9 benzodiazepines?
chlordiazepoxide
clorazepate
diazepam
flurazepam
lorazepam
midazolam
oxazepam
temazepam
triazolam
Name 7 miscellaneous sedative/hypnotics?
droperidol
promethazine
chloral hydrate
dexmedetomidine
hydroxyzine
zaleplon
zolpidem
Sedatives are used to provide _____, usually prior to procedures.
sedation
Hypnotics are used to manage ______.
insomnia
Selected agents are useful as? (5)
anticonvulsants
(clorazepate, diazepam,
phenobarbital)
skeletal muscle relaxants
(diazepam)
adjuncts in the management of
alcohol withdrawal
syndrome
(chlordiazepoxide,
diazepam, oxazepam)
as adjuncts in general
anesthesia (droperidol)
adjuncts in amnestics
(midazolam, diazepam)
Sedative/hypnotics cause generalized CNS _______. May produce tolerance with chronic use and have potential for psychological or physical dependence. These agents have ___ analgesic properties.
depression
NO
Contraindications?
Hypersensitivity. Avoid using during pregnancy or lactation. Should not be used in ____ patients nor in those with pre-existing CNS depression.
comatose
Contraindications?
Should not be used in patients with uncontrolled severe _____.
pain
Precautions?
Use cautiously in patients with _____ dysfunction, severe _____ impairment, or severe underlying _____ disease.
hepatic
renal
pulmonary
Precautions?
Use with caution in patients who may be _____ or who may have had previous drug addictions.
suicidal
Precautions?
Hypnotic use should be short-term. Geriatric patients may be more sensitive to ____ depressant effects; dosage reduction may be required.
CNS
Interactions?
Additive CNS depression with (name 5).
alcohol
antihistamines
some antidepressants
opioid analgesics
phenothiazines
Interactions?
_____ induce hepatic drug-metabolizing enzymes and can decrease the effectiveness of drugs metabolized by the liver, including oral contraceptives.
Barbiturates
Interactions?
Should not be used with _____ inhibitors.
MAO
ASSESSMENT:
Monitor blood pressure, pulse, and respiratory status frequently throughout IV administration. Prolonged high-dose therapy may lead to psychological or physical dependence. Restrict the amount of drug available to patient, esp if patient is depressed, suicidal, or has a history of addiction.
okay
What are 4 major conditions to ASSESS for when taking sedative/hypnotics?
insomnia
seizures
muscle spasms
alcohol withdrawal
What is the ASSESSMENT for INSOMNIA?
Assess sleep patterns before and periodically throughout course of therapy.
What are 3 seizure-related assessments to make when patient is taking sedative/hypnotics?
observe and record:
intensity
duration
characteristics of seizure
activity
(institute seizure precautions)
What are 3 muscle spasm-related assessments to make before and throughout therapy when patient is taking sedative/hypnotics?
assess:
muscle spasms
associated pain
limitation of movement
What are 4 alcohol withdrawal-related assessments to make when patient is taking sedative/hypnotics?
tremors
agitation
delirium
hallucinations
(protect patient from injury)
List 3 potential nursing diagnoses?
Sleep pattern disturbed
Injury, risk for (s.e.)
Knowledge, deficient, related
to disease processes and
medication regimen
IMPLEMENTATION:
Name four safety implements.
1. Supervise ambulation and transfer of patients following administration of hypnotic doses.
2. Remove cigarettes.
3. Side rails should be
raised and call bell within reach at all times.
4. Keep bed in low position.
Discuss the importance of preparing the environment for sleep. Name 4 ways.
darken room
quiet the room
avoid nicotine
avoid caffeine

If less effective after a few weeks, consult hcp; do not increase dose. Gradual withdrawal may be required may be required to prevent reactions following prolonged therapy.
IMPLEMENTATION:
May cause ____ drowsiness. Caution patient to avoid driving and other activities requiring alertness until response to medication is known.
daytime
IMPLEMENTATION:
Advise patient to avoid the use of alcohol and other CNS depressants concurrently with these medications.
okay
Advise patient to inform hcp if pregnancy is planned or suspected.
okay
EVALUATION:
Effectiveness of therapy can be demonstrated by? (5)
Improvement in sleep patterns...control of seizures....decrease in muscle spasms...decreased tremulousness...more rational ideation when
used for alcohol withdrawal.