CH 22: Anxiolytic -- Lorazepam (Benzodiazepine aka benzos)

CH 22: Antipsychotics and Anxiolytics. Yellow: drug prototype | purple: concept | * = deemed important by chatgpt

(4) A patient who takes thioridazine to treat schizophrenia is noted to be restless and fidgety and is pacing around the room. The nurse caring for this patient will perform which action?

a. Contact the provider to discuss changing to benztropine.

b. Notify the provider of these symptoms and request an order for lorazepam.

c. Question the patient about adherence to the drug regimen.

d. Recognize that patients with schizophrenia normally present in this fashion

ANS: B

if a patient takihg an antipsychotic (thioriudazine) suddenly appears to have acute dystonia (restless, and fidgety), a treatment to this side effect of movement disorder is to (B) notify provider of symptosm and request lorazepam as an order

→ how does an anti-psychotic cuase movement disorders? : this medication blocks dopamine in the brian. this then leads to akathasia.

→ how does lorazepam (benzos - muscle relaxant) relieve akathasia? dopamine is the trigger of releasing GABA, wehich is an inhibitory neurotransmitter for muscle movement.

lorazepam (drug) Benzodiazepine (drug class): lorazepam used for akathia/restlessness

(10) A family member of a patient who has been taking fluphenazine for 3 months calls to report that the patient is exhibiting agitation and restlessness. The nurse learns that the patient’s delusional thinking and hallucinations have stopped since taking the medication. The nurse will perform which action?

a. Reassure the family member that tolerance to these side effects will subside over time.

b. Remind the family member that complete drug effects may not occur for several more weeks.

c. Suggest that the family member contact the provider to discuss an order for a medication to help with the agitation and restlessness.

d. Tell the family member to withhold the medication and notify the patient’s provider

ANS: C

for a patient taking an antipsychotic, the relief of symptoms and the presence of akathisia (movement disorders) is a sign that the nurse must (C) suggest to the family to contact provider to order medication for restlesness (e.g., benzodiazepine, or muscle relaxants)

→ anti-psychotics (e.g., fluphenazine): leads to movement disorders as sid effects

→ contact provider for muscle relaxants: this helps relieve the side effects that was caused while curing delusions of the patient

lorazepam (drug) Benzodiazepine (drug class): benzodiazepine tolerance with long-term use

*(12) The nurse is performing a medication history on a patient who reports taking lorazepam for the past 6 months to treat an anxiety disorder. The patient states that the medication is not working as well as it previously did. The nurse will

a. contact the provider to discuss changing to another benzodiazepine.

b. tell the patient to double their dose.

c. suspect worsening of the anxiety disorder.

d. understand that the patient has likely developed tolerance to this drug.

ANS: D

the patient is seen taking lorezepam for six months for anxiety, but is seen to have weaker effects. this is proof that the patient has (D) tolerance to the drug.

lorazepam (drug) Benzodiazepine (drug class) — benzodiazepines tolerance with long-term use

*(16) A patient is brought to the emergency department with decreased respirations and somnolence. The nurse notes a heart rate of 60 beats per minute and a blood pressure of 80/58 mm Hg. The patient is known to take alprazolam to treat anxiety. Which medication will the nurse anticipate the provider to order?

a. Benztropine

b. Flumazenil

c. Lorazepam

d. Propranolol

ANS: B

the patient taking alprazolam for anxiet is seen having bradycardia, and hypotension. the nurse will anticipate the doctor’s orders of (B) flumazenil

→ flumazenil: is a benzodiazepine receptor agonist. it directly relieves benzodiazepine overdose

lorazepam (drug) Benzodiazepine (drug class) — alprazolam overdose & flumazenil antidote

*(17) A patient arrives in the emergency department complaining of difficulty breathing, dizziness, sweating, and heart palpitations. The patient reports having had similar episodes previously due to stress at work. The nurse will expect the provider to order which medication?

a. Flumazenil

b. Haloperidol

c. Lorazepam

d. Propranolol

ANS: C

the symptoms iterated are signs of anxiety. these episodes will be expected to be treated by giving (C) lorazepam

—> lorazepam: muscle relaxants. help relieving the physical manifestations of anxiety

lorazepam (drug) benzodiazepine (drug class) — lorazepam used for acute anxiet/panic symptoms

*(18) The nurse is teaching a patient about taking a benzodiazepine to treat grief-related anxiety. Which statement by the patient indicates understanding of the teaching?

a. “I may have wine with dinner to help with relaxation.”

b. “I may need to take this medication forever.”

c. “I may stop taking the medication when my symptoms go away.”

d. “I should try psychotherapy or a support group in addition to the medication.”

ANS: D

aside from the anti-anxiety medications (loarazepam), the patient should also try non-pharm treatments such as (D) psychotherapy or support groups.

lorazepam (drug) benzodiazepine (drug class) — benzodiazepine teaching:

• no alcohol

• psychotherapy/support groups

• do not stop abruptly