Sedatives and Hypnotics Study Flashcards

Ch20: Sedatives and Hypnotics

Learning Objectives

• Differentiate between sedatives and hypnotics

• Explain uses, actions, adverse reactions, contraindications, precautions, and interactions

• Describe important nursing assessments for clients taking sedatives/hypnotics

• Identify relevant nursing diagnoses

• Examine ways to promote optimal response and manage adverse reactions

• Discuss key points for client education

Understanding Insomnia

• Definition: Difficulty falling asleep or staying asleep

• Common Causes:

  • Lifestyle changes

  • New job

  • Jet lag

  • Chronic pain

  • Headache

  • Stress

  • Anxiety

Classification of Sedatives and Hypnotics

• Barbiturates: Limited use

• Nonbarbiturates

• Benzodiazepines:

  • Examples: temazepam, triazolam

• Nonbenzodiazepines:

  • Examples: eszopiclone, zolpidem

Pharmacological Actions

• Barbiturates:

  • CNS depression

  • Mood alterations

  • Respiratory depression

• Benzodiazepines:

  • CNS depression

  • Enhance GABA effects

  • Less respiratory depression

• Nonbenzodiazepines:

  • CNS depression

  • Effects diminish after approximately $2$ weeks

  • Potential for tolerance, dependence, and withdrawal

Clinical Uses

• Insomnia

• Convulsions or seizures

• Preoperative sedation

• Conscious sedation

Review Question #1

• Which of the following drugs purposely induces drowsiness?

  • A) Anxiolytic

  • B) Sedative

  • C) Hypnotic

  • D) Opioid

Adverse Reactions and Contraindications

• Adverse Reactions:

  • Dizziness

  • Drowsiness

  • Headache

  • Nausea

• Contraindications:

  • Hypersensitivity

  • Coma

  • Severe respiratory problems

  • History of drug/alcohol abuse

  • Pregnancy/lactation (category dependent)

Precautions and Interactions

• Precautions:

  • Lactation

  • Hepatic/renal impairment

  • Habitual alcohol use

  • Mental health problems

• Interactions:

  • Potential for increased sedation with other CNS depressants (e.g., antihistamines, alcohol)

Review Question #2

• A client taking antihistamines is prescribed sedatives for anxiety. What's a possible interaction effect?

  • A) Restlessness

  • B) Increased sedation

  • C) Headache

  • D) Chronic pain

  • Answer: B) Increased sedation

Nursing Process: Assessment

• Preadministration Assessment:

  • Vital signs (especially blood pressure)

  • Level of consciousness

  • Behavioral observations

  • Environmental factors affecting sleep

  • Sleep patterns and history

  • Current medications

• Ongoing Assessment:

  • Reasons for inadequate sleep

  • Vital signs before each administration

  • Drug effectiveness

Nursing Diagnoses

• Injury Risk related to impaired memory

• Altered Breathing Pattern related to respiratory depression

• Coping Impairment related to excessive medication use

Nursing Process: Planning

• Expected client outcomes:

  • Optimal response to therapy

  • Management of adverse drug reactions

  • Understanding of prescribed medication regimen

Nursing Process: Implementation (1)

• Promoting Optimal Response:

  • Provide supportive care (back rubs, night lights, quiet atmosphere)

  • Avoid caffeine

  • Ensure medication security

  • Educate on proper timing of medication

Review Question #3

• Which measures ensure optimal response to hypnotic therapy? (Select all that apply)

  • A) Back rubs

  • B) Alcohol intake

  • C) Night lights

  • D) Darkened room

  • E) Bedtime coffee

  • Answer: A, C, and D are correct.

Nursing Process: Implementation (2)

• Managing Injury Risk:

  • Monitor for adverse reactions

  • Implement safety measures (bed rails, assistance with ambulation)

  • Assess client regularly after drug administration

  • Educate on avoiding hazardous activities

Nursing Process: Implementation (3)

• Managing Altered Breathing Pattern:

  • Assess respiratory function before and after administration

  • Educate on avoiding alcohol

• Managing Coping Impairment:

  • Limit administration to $2$ weeks

  • Emphasize proper dosage adherence

  • Monitor for dependency and withdrawal symptoms

Client Education

• Key Points:

  • Short-term use only

  • Report ineffectiveness or adverse reactions

  • Avoid alcohol

  • Exercise caution with activities

  • Proper administration (timing, food interactions)

  • Pregnancy and breastfeeding precautions

  • Interactions with OTC medications

Case Study

• A client is prescribed temazepam (Restoril) $15$ mg at bedtime for insomnia.

• Questions to consider:

  • Is temazepam a sedative or hypnotic?

  • What's the difference between sedatives and hypnotics?

  • What key points should be included in the client education plan?

Key Takeaways

• Sedatives and hypnotics are crucial in managing sleep disorders.

• Proper assessment and monitoring are essential for safe administration.

• Client education is vital for medication effectiveness and safety.

• Short-term use is recommended to prevent dependency.

• Nurses play a critical role in promoting optimal therapeutic response and managing potential risks.