Author Question: A patient who is complaining of anxiety and difficulty sleeping has asked what prescription ... (Read 17 times)

kodithompson · **on:** Jul 23, 2018

A patient who is complaining of anxiety and difficulty sleeping has asked what prescription medications would assist in getting to sleep. What would be appropriate responses? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.

1. Diphenhydramine (Benadryl)
2. Valerian root
3. Ramelteon (Rozerem)
4. Flurazepam (Dalmane)
5. Zolpidem (Ambien)

Question 2

Which situation would lead to an increase in cardiac output?

1. Reduced cardiac contractility
2. Hypovolemia
3. Peripheral vascular resistance
4. Increase in preload

chereeb · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

3,4,5
Rationale 1: Diphenhydramine (Benadryl) can be obtained over the counter and does not need a prescription to obtain. It does promote getting to sleep.
Rationale 2: Valerian is an herbal product that does not need a prescription to obtain. It does promote getting to sleep.
Rationale 3: Rozerem is a newer, nonbenzodiazepine hypnotic approved to treat chronic insomnia in people who have problems falling asleep.
Rationale 4: Benzodiazepines are drugs of choice for generalized anxiety disorder and the short-term therapy of insomnia. Flurazepam (Dalmane) should be taken at bedtime because it quickly produces significant drowsiness.
Rationale 5: Ambien is a sedative-hypnotic approved for short-term treatment of insomnia.
Global Rationale: Rozerem is a newer, nonbenzodiazepine hypnotic approved to treat chronic insomnia in people who have problems falling asleep. Benzodiazepines are drugs of choice for generalized anxiety disorder and the short-term therapy of insomnia. Flurazepam (Dalmane) should be taken at bedtime because it quickly produces significant drowsiness. Ambien is a sedative-hypnotic approved for short-term treatment of insomnia. Diphenhydramine (Benadryl) can be obtained over the counter and does not need a prescription to obtain. It does promote getting to sleep. Valerian is an herbal product that does not need a prescription to obtain. It does promote getting to sleep.

Answer to Question 2

4
Rationale 1: A reduction in cardiac contractility results in lower preload and subsequent cardiac output.
Rationale 2: Hypovolemia is a lower blood volume and will result in lower cardiac output.
Rationale 3: Peripheral vascular resistance increases afterload and increases the workload on the heart.
Rationale 4: Increased preload results in a more forceful contraction and increases cardiac output.
Global Rationale: Increased preload results in a more forceful contraction and increases cardiac output. A reduction in cardiac contractility results in lower preload and subsequent cardiac output. Hypovolemia is a lower blood volume and will result in lower cardiac output. Peripheral vascular resistance increases afterload and increases the workload on the heart.