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25 Cards in this Set
- Front
- Back
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Very short acting barbituate used to produce anethesia |
Pentothal (Thiopental) |
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Why are short acting hypnotics useful? |
Because they allow patient to awaken early in the AM with no lingering effect |
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What are intermediate hypnotics used for? |
For sustaining sleep May experience hangover (drowsiness) in the morning |
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How long should hypnotics be used for ? |
Short term period to prevent drug dependence and tolerance. |
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What can abruptly discontinuing a high dose of hypnotics do? |
Cause withdrawal symptoms. Dose should be tapered to avoid this. |
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What type of patients should avoid hypnotics? |
Patients with severe respiratory disorders because hypnotics increase resp. depression |
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Used to treat chronic insomnia and is the only sedative hypnotic approved for long term |
Ramelton (Rozerum) |
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What is phenobarbital classified as, what does it do and what should you monitor for? |
Long acting Barbituate. Controls seizures in epilepsy, used for pre-op sedation, anxiety. Monitor for respiratory depression |
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What are seconal and nembutal classified as, what do they do and what should you monitor for? |
Short acting barbiturates. Used for pre-op sedation. Monitor for sleep related behaviors & suicide thoughts |
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What are amytal, alurate & butisol classified as, what do they do and what should you monitor for? |
Intermediate acting barbiturates. Sleep sustainers, helps patients stay asleep (take 1 hour before bed) not recommended for those who have trouble getting to sleep. Monitor for abnormal thinking, angioedema. |
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Which barbiturates should older adults avoid? |
Amytal, alurate, butisol. |
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This drug group is ordered as S/H for inducing sleep |
Benzodiazephine |
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If anxiety is the cause for insomnia, which benzodiazephine would be used? |
Ativan |
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Xanax, Dalmane, Restoril, Halcion, ProSom, Doral |
Benzodiazephine |
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Which S/H increase the action of the inhibitory neurotransmitter receptors and reduce neuron excitability. |
Benzodiazephine |
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Which type of S/H can depress stage 4 REM sleep which may result in vivid nightmares, has rapid onset action, has intermediate to long acting effects and are well absorbed thru GI mucosa |
Benzodiazephine |
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What is Ambien classified as, what is it used for? |
Nonbenzodiazephine. Used for short term treatment for insomnia (less than 10 days) |
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Prototype : Ambien. Classification & schedule. Therapeutic use. Side effects. Adverse effects. Interventions |
Classification: Nonbenzodiazephine, sched IV Therapeutic use: Short term treatment of insomnia. Side effects: Drowsy, lethargy, headache, hot flash, hangover, ataxia, anxiety,n/v Adverse: Tolerance, dependance, sleep related behaviors, hypotension, dysrhytmias, suicide thought |
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What should the nurse look for during the assessment before administering Benzodiazephines? |
History of meds, especially CNS depressants which could potentiate resp depression. Determine if there is a history of anxiety or insomnia. Assess renal function (renal impairment can increase half life of drug) |
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Nursing Diagnosis related to Benzodiazephines |
Sleep deprivation related to adverse effect of insomnia. Risk for injury due to dizziness. Ineffective breathing pattern related to CNS depression. |
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Nursing interventions when administering Benzo's |
Monitor vitals , especially respirations and blood pressure. Use bed alarm when recieving for first time - confusion may occur. Examine for skin rashes. |
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What can interact with benzodiazephines? |
Alcohol, antidepressants, opioids (can cause resp depression) Herbal supplements |
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What should the nurse look for in the assessment when administering nonbenzodiazephines |
Make sure patient is not taking CNS depressants. Find out the cause of sleep disturbance |
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Nursing Diagnosis related to nonbenzodiazephines |
Sleep deprevation related to anxiety Fatigue related to insomnia Risk for injury related to adverse effects |
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Interventions for patients taking Nonbenzodiazephines |
Monitor vitals, check for respiratory depression (slow, irregular breaths). Use bed alarm, confusion may occur. Observe for side effects (hangover, lightheadedness, dizziness, confusion) Suggest patient urinate before bed to avoid sleep disruption Advise to take before bed. |
