A graduate school nurse has to prepare a presentation for a freshman class of nursing students on anxiolytic and hypnotic agents. The learning objectives include a review of the states that are affected by anxiolytic and hypnotic agents and key nursing considerations for patients receiving these medications. (Learning Objectives 1, 2, and 5)

a.What are the definitions of the states affected by anxiolytic or hypnotic agents?

b.What are the key nursing implementation considerations for a patient receiving a benzodiazepine?

c.What should the nurse teach the students about the indications for zaleplon (Sonata) and zolpidem (Ambien)?

Case Study, Chapter 23, Antiseizure Agents

A patient had a tonic–clonic seizure and has been started on a phenytoin medication. The patient tells the nurse he is very upset about not being able to drive and has several questions about epilepsy. (Learning Objectives 1, 2, and 5)

a.What should be included in the patient teaching about the classification of generalized seizures?

a.How does phenytoin work?

c.What are the key implementation and rationale considerations for this patient who is receiving medication to treat generalized seizures?

Case Study, Chapter 26, Narcotics, Narcotic Antagonists, and Antimigraine Agents

A new graduate RN has been assigned to a medical–surgical unit. The new graduate RN is in the week of nursing orientation and is administering medications. The RN has to administer an antimigraine medication to an adult patient, a narcotic to an older adult in acute pain, and a narcotic antagonist to a third patient. (Learning Objectives 1, 2, 3, and 5)

a.What is the gate control theory of pain, and how does this block pain for a patient?

b.What are the key lifespan considerations for an older adult when administering narcotics?

c.What are the key nursing implementation considerations for a patient receiving a narcotic antagonist?

d.What are the key lifespan considerations for an adult when administering antimigraine medication?

Case Study, Chapter 30, Adrenergic Agonists

A patient is experiencing serious ventricular arrhythmias and shock following a heart transplant. The physician has ordered isoproterenol and dopamine to be administered to the patient. (Learning Objectives 2, 4, and 5)

a.What is the therapeutic action for isoproterenol?

b.What are the adverse effects of isoproterenol?

c.What is the therapeutic action for dopamine?

d.What are the adverse effects of dopamine?

e.What are the key nursing implementation considerations for patients receiving an adrenergic agent?

Case Study, Chapter 36, Adrenocortical Agents

A second-year nursing student has to prepare medication cards for clinical on adrenocortical agents. The specific medication cards that have to be prepared are for prednisone (Deltasone) and fludrocortisone (Florinef). Additionally, the student nurse has to prepare a patient teaching plan for mineralocorticoids. (Learning Objectives 1, 2, 4, and 5)

a.What are the physiological effects of the adrenocortical agents?

b.What are the key nursing implementation teaching points that need to be reviewed with a patient receiving an adrenocortical agent?

c.What are the most common adverse reactions for fludrocortisone (Florinef)?

d.What are the indications for prednisone (Deltasone)?

Case Study, Chapter 38, Agents to Control Blood Glucose Levels

A diabetes registered nurse educator is preparing an in-service presentation for student nurses on agents to control blood glucose levels for diabetes mellitus. The in-service will include a brief review of the pathophysiology of diabetes mellitus. Drugs to be included in the presentation will include insulin, chlorpropamide (Diabinese), glyburide (Micronase), and metformin (Glucophage). (Learning Objectives 1, 4, and 5)

a.What alterations in metabolic pathways and changes to basement membranes occur with diabetes mellitus?

b.What are the key nursing implementation considerations for patients taking insulin?

c.What are the indications for chlorpropamide (Diabinese)?

d.What are the most common adverse effects of glyburide (Micronase)?

e.What are the therapeutic actions for metformin (Glucophage)?

f.What are the lifespan considerations for children who use antidiabetic agents?