Author Question: A patient is brought to the emergency department by friends, who say that they were at a party where ... (Read 242 times)

JGIBBSON · **on:** Jul 23, 2018

A patient is brought to the emergency department by friends, who say that they were at a party where alcohol and a mix of barbiturates and benzodiazepines were all available.

They tell the nurse that the patient was among the first to arrive at the party, which started several hours ago. The patient is nonresponsive and has pinpoint pupils and respirations of 6 breaths per minute. After oxygen has been administered, the nurse should prepare the patient for which intervention?
a. A central nervous system stimulant and IV fluids
b. Activated charcoal and flumazenil (Romazicon)
c. Gastric lavage and possible hemodialysis
d. Naloxone (Narcan) and a cathartic

Question 2

A patient who travels frequently for business reports occasional instances of being unable to fall asleep. The patient tells the nurse that job demands require staying up late and then getting up early for meetings.

The nurse expects that the provider will prescribe which medication for this patient?
a. Flurazepam
b. Trazodone (Desyrel)
c. Zaleplon (Sonata)
d. Zolpidem (Ambien)

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

Answer to Question 1

ANS: C
Because time has elapsed, enough medication is present in the system to warrant elimination by hemodialysis, and any remainder in the stomach may be eliminated by gastric lavage. A central nervous system stimulant is contraindicated, and intravenous fluids do not address the overdose. Although activated charcoal may assist in absorption of medication in the gut, flumazenil will be effective only for the benzodiazepines. Naloxone, a narcotic antagonist, is not effective for barbiturates and benzodiazepines.

Answer to Question 2

ANS: C
Zaleplon (Sonata) works well for people who have trouble falling asleep and, because of its short duration of action, can be taken late at night without causing a hangover or next-day sedation early in the morning. Zolpidem (Ambien) has a longer duration and is a good choice for patients who have difficulty maintaining sleep. Flurazepam has a long duration of action. Trazodone causes daytime grogginess.