Older adults who take long-acting sedatives or hypnotics are likely to experience:
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Solution
Ataxia
If longer-acting barbiturates are used in older adults, these clients may experience daytime sedation, ataxia, and memory deficits.
A patient is admitted to the emergency department with an overdose of a benzodiazepine. The nurse immediately prepares to administer which of the following antidotes from the emergency drug cart?
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Solution
flumazenil (Romazicon)
Flumazenil is the antidote for benzodiazepine overdoses.
Select all that apply that is appropriate when there is a benzodiazepine overdose:
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Solution
Answer: 2, 3, and 5
If ingestion is recent, decontamination of the GI system is indicated. The administration of syrup of ipecac is contraindicated because of aspiration risks related to sedation. Gastric lavage is generally the best and most effective means of gastric decontamination. Activated charcoal and a saline cathartic may be administered to remove any remaining drug. Hemodialysis is not useful in the treatment of benzodiazepine overdose. Flumazenil can be used to acutely reverse the sedative effects of benzodiazepines, though this is normally done only in cases of extreme overdose or sedation.
Select all that apply to the use of barbiturates in treating insomnia:
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Solution
Answer: 2, 4, and 5
Barbiturates deprive people of REM sleep. When the barbiturate is stopped and REM sleep once again occurs, a rebound phenomenon occurs. During this phenomenon, the persons dream time constitutes a larger percentage of the total sleep pattern, and the dreams are often nightmares.
A hospitalized client is prescribed chloral hydrate (Noctec). The nurse includes which action in the plan of care?
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Solution
Instruct the client to call for ambulation assistance
Chloral hydrate is a sedative. This medication does not affect cardiac function. Blood pressure changes are not significant with the use of this medication. A client should call for assistance to the bathroom at night. Additionally, the client may experience residual daytime sedation; therefore, the nurse should instruct the client to call for ambulation assistance during the daytime hours.
A client has a diagnosis of primary insomnia. Before assessing this client, the nurse recalls the numerous causes of this disorder. Select all that apply:
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Solution
Answer: 1, 4, and 6
Acute or primary insomnia is caused by emotional or physical discomfort not caused by the direct physiologic effects of a substance or a medical condition. Excessive caffeine intake is an example of disruptive sleep hygiene; caffeine is a stimulant that inhibits sleep. Environmental noise causes physical and/or emotional and therefore is related to primary insomnia.
A female client verbalizes that she has been having trouble sleeping and feels wide awake as soon as getting into bed. The nurse recognizes that there are many interventions the promote sleep. Check all that apply.
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Solution
Answer: 3, 5, and 6
Lying in bed when one is unable to sleep increases frustration and anxiety which further impede sleep; other activities, such as reading or watching television, should not be conducted in bed. Counting backwards requires minimal concentration but it is enough to interfere with thoughts that distract a person from falling asleep.
A nursing measure to promote sleep in school-age children is to:
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Solution
Encourage quiet activities prior to bed time.
The amount of sleep needed during the school years is individualized because of varying states of activities and levels of health. A 6-year old averages 11-12 hours of sleep nightly, whereas an 11-year old sleeps about 9-10 hours. The 6- or 7-year old can usually be persuaded to go to bed by encouraging quiet activities.
Narcolepsy can be best explained as:
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Solution
An overwhelming wave of sleepiness and falling asleep
Narcolepsy is a dysfunction of mechanisms that regulate the sleep and wake states. Excessive daytime sleepiness is the most common complaint associated with this disorder. During the day a person may suddenly feel an overwhelming wave of sleepiness and fall asleep; REM sleep can occur within 15 minutes of falling asleep.
A client taking a beta adrenergic blockers for HTN can experience interference with sleep patterns such as:
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Solution
Increased daytime sleepiness
Beta Blockers can cause nightmares, insomnia, and awakenings from sleep.