A patient who has been taking alprazolam Xanax to treat ...

[OSWALD]

A patient who has been taking alprazolam Xanax to treat generalized anxiety disorder (GAD) reports recently stopping the medication after symptoms have improved but reports having feel-ings of panic and paranoia.
 
  Which initial action by the nurse is correct? a. Ask the patient if the medication was stopped abruptly.
  b. Instruct the patient to resume taking the alprazolam.
  c. Notify the provider that the patient is ex-periencing a relapse.
  d. Suggest that the patient discuss taking buspirone Buspar with the provider.

Question 2

A nurse is assisting a physician who is preparing to suture a superficial laceration on a patient's leg. The physician asks the nurse to draw up lidocaine with epinephrine. The nurse understands that epinephrine is used with the lidocaine to:
 
  a. allow more systemic absorption to speed up metabolism of the lidocaine.
  b. increase the rate of absorption of the lido-caine.
  c. improve perfusion by increasing blood flow to the area.
  d. prolong anesthetic effects and reduce the risk of systemic toxicity from lidocaine.

[jharrington11]

Answer to Question 1

A
Long-term use of benzodiazepines can cause physical dependence, with symptoms of panic, pa-ranoia, and delirium occurring with abrupt withdrawal. These symptoms can be confused with symptoms of relapse of anxiety, so the nurse should evaluate this by first asking about how the medication was discontinued. If the symptoms are caused by a relapse, the patient should resume taking the alprazolam. Buspirone is not indicated.

Answer to Question 2

D
Epinephrine causes vasoconstriction, which reduces local blood flow and delays systemic ab-sorption of lidocaine, which prolongs local anesthetic effects and reduces the risk of systemic toxicity. Epinephrine slows the rate of absorption. Epinephrine delays systemic absorption of li-docaine, so metabolism is slowed and the effects are prolonged in the periphery. Epinephrine does not increase local blood flow.

[OSWALD]

Excellent

[Kedrick2014]

TYSM