MISC
what are sedative-hypnotics used for?
antianxiety effects- low doses
Produce sleep- high doses
general anesthetic- large doses
What is the reversal agent for benzodiazepines? What would you assess before administering
Flumazenil. You better check that resp. status.
Assess LOC and put on seizure precaution-per drug book
What are potential withdrawal symptoms for barbiturates.
SEIZURES
What are affective disorders?
Illnesses that affect the way you think of feel.
*depression and bipolar disorder
What drug class is commonly used for children/teens with depression
SSRI, monitor for SE
Name the 4 sedative-hypnotics classes
Barbiturates, Benzodiazepines, Non-benzodiazepines, Melatonin agonist
What is a common symptom of benzodiazepines toxicity?
Amnesia, coma, resp depression.
What are some symptoms of anxiety
tachycardia, tachypnea, increased BP, dilated pupils
Name the symptoms of Affective mood disorders.
flat affect, poor grooming habits, no energy, no pleasure (anhedonia), feeling of worthlessness/hopelessness, suicide risk
List all symptoms of serotonin syndrome.
hallucinations, diaphoresis, agitation, can be life threatening
Patient teaching points for sedative-hypnotics including side effects
No alcohol, No other CNS depressants, Elderly have liver and kidney function test; Drowsiness, Dizziness, Lightheaded
List all uses for benzodiazepines
anxiety, seizures, sedation, panic, alcohol withdrawal, pre-op sedation.
Match the anxiety levels with each definition
A.Mild. 1.reduction in focus and cognitive ability
B.Moderate. 2. alert- may enhance learning
C.Severe. 3. difficult functioning, thinking
D.Panic. 4. focus on immediate concern only
A. 2
B. 4
C. 1
D. 3
Priority assessment for affective disorder.
Monitor electrolytes- LITHIUM LEVELS
Teaching points for patients taking MAOI
Avoid smoked, aged, or pickled foods. doesn't interact well with other foods.
Important assessments the nurse must carry out in relation to sedative-hypnotics
RESP. DEPRESSION, cns depression, apnea, death
ASSESS RESPIRATIONS!!!
What labs would you monitor for benzodiazepines and barbiturates
kidney and liver function
Name anxiety coping mechanisms.
Conversion- psychological conflict into physical symptoms
Regression- returns to earlier stage of behavior
Rationalization- makes excuses
Denial- conflict is blocked
List drug classes the treat depression
TCA, SSRI, SNRI, MAOI
What can happen if a patient is noncompliant taking MAOIs regarding the diet.
can be fatal, hypertensive crisis, H/A, Increase BP.
give examples of sleep hygiene techniques
have a sleep schedule, avoid lights, no caffeine, nicotine, or large meals before bed, avoid exercise before bed, avoid large amounts of fluid before bed etc.
List side effects for barbiturates.
respiratory depression, depression, drowsiness, delirium, bronchospasm, constipation, N/V, photosensitivity, etc.
Name nonpharmacological anxiety interventions.
provide calm, quiet environment, establish trust, self care,
What are common side effects of TCA's not usually seen with other antidepressants.
Cardiotoxicity
What is the therapeutic lithium level? What SE would prompt the nurse to call the HCP immediately.
0.6-1.2mEq/L- Diarrhea, vomiting, excess sweating, lethargy, excess urination, slurred speech