A patient with a history of resolved substance abuse and who has ...

[joblessjake]

A patient with a history of resolved substance abuse and who has been pacing, disorganized, mumbling to himself, trembling, and intrusive has just been given 10 mg of PRN intramuscular diazepam (Valium) after responding threateningly to a peer who
 
  asked him to lend him money. Important nursing interventions at this point include: (Select all that apply.) a. Teach the patient about side effects and the importance of using the medication as prescribed.
  b. Monitor the patient's vital signs and behavior to determine his response to the medication.
  c. Stay with the patient to provide reassurance and support, and provide for any safety needs that might develop.
  d. Support the long-term use of benzodiazepine medications to assure that his disorder is adequately treated.
  e. Advise the patient to avoid salty foods or other sources of high levels of sodium while taking benzodiazepines.
  f. Discourage the patient from stimulating activities or substances such as basketball or caffeine.

Question 2

With every medication there is a tradeoff between therapeutic effects and
 
  1. costs.
  2. convenience.
  3. unwanted remarks.
  4. unwanted reactions.

[Ashley I]

Answer to Question 1

B, C, F
Benzodiazepine anxiolytics are helpful for quickly reducing high levels of anxiety. Given that this patient is experiencing severe anxiety to panic, such medications are indicated, as is continued direct monitoring of the patient to assess his response and assure his safety. However, they do have side effects, can interact with other sedative medications, and are prone to be misused by persons susceptible to drug abuse. Therefore it is important to monitor for side effects as well as desired effects and to discourage long-term use or reliance on these medications when there is risk of abuse, tolerance, or addiction (particularly in a patient with a history of substance abuse). Teaching about side effects and other important considerations pertinent to these medications would typically be an appropriate nursing intervention, but it would be inappropriate to do so while the patient was so highly anxious. Teaching should be deferred until his anxiety levels are reduced to a mild or moderate level. Benzodiazepines do not require a controlled-sodium diet. They do not affect, nor are they affected by, sodium levels or intake. Stimulating activities or psychostimulant substances would tend to worsen anxiety and interfere with the desired effect of the medications, so such stimulation should be discouraged.

Answer to Question 2

4
Every medication has side effects.

[joblessjake]

Gracias!

[phuda]

Excellent