Author Question: A patient in the emergency department is given intravenous diazepam (Valium) for seizures. When the ... (Read 109 times)

iveyjurea · **on:** Jul 23, 2018

A patient in the emergency department is given intravenous diazepam (Valium) for seizures. When the seizures stop, the nurse notes that the patient is lethargic and confused and has a respiratory rate of 10 breaths per minute.

The nurse will expect to administer which of the following?
a. Flumazenil (Romazicon)
b. Gastric lavage
c. Respiratory support
d. Toxicology testing

Question 2

A patient who has been using secobarbital for several months to treat insomnia tells the nurse that the prescriber has said the prescription will be changed to temazepam (Restoril) because it is safer.

The patient asks why this agent is safer. The nurse is correct in telling the patient that temazepam:
a. does not depress the central nervous system.
b. shows no respiratory depression, even in toxic doses.
c. mimics the actions of a central nervous system inhibitory neurotransmitter.
d. only potentiates the action of endogenous gamma-aminobutyric acid (GABA).

meltdown117 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: C
When benzodiazepines are administered IV, severe effects, including profound hypotension, respiratory arrest, and cardiac arrest, can occur. Respiration should be monitored, and the airway must be managed if necessary. Flumazenil (Romazicon) is a competitive benzodiazepine receptor antagonist and is used to reverse the sedative effects but may not reverse respiratory depression. Gastric lavage would not be effective, because the benzodiazepine has been given IV. Without further indication of the ingestion of other drugs, toxicology testing is not a priority.

Answer to Question 2

ANS: D
Benzodiazepines potentiate the actions of GABA, and because the amount of GABA in the CNS is finite, these drugs' depressive effect on the CNS is limited. Benzodiazepines depress the CNS but not to the extent that barbiturates do. Benzodiazepines are weak respiratory depressants at therapeutic doses and moderate respiratory depressants at toxic doses. Barbiturates mimic GABA; therefore, because they produce CNS depression, this effect is limited only by the amount of barbiturate administered.