A nurse is caring for a client who is experiencing alcohol withdrawal and is receiving chlordiazepoxide (Librium) as an anxiolytic. Which of the following assessments should the nurse monitor? (Select all that apply.).

Monitor oxygen saturation and end-tidal CO2 levels.This is because midazolam (Versed) is a benzodiazepine that can cause respiratory depression and sedation, especially when given intravenously. The nurse should monitor the client’s oxygenation and ventilation status during and after the procedure to prevent hypoxia and hypercapnia.

Choice A is wrong because naloxone (Narcan) is an opioid antagonist that reverses the effects of opioids, not benzodiazepines.Naloxone would not prevent respiratory depression caused by midazolam.

Choice C is wrong because giving midazolam with food or milk would not prevent respiratory depression.Food or milk may delay the absorption of oral midazolam, but it would not affect the intravenous administration.

Choice D is wrong because reducing the dose of midazolam by half may not be sufficient to prevent respiratory depression.The dose of midazolam should be individualized based on the client’s age, weight, health status, and response to the drug. Reducing the dose by half may also compromise the quality of sedation and analgesia during the colonoscopy.

The nurse should monitor the client’s blood pressure, respiratory rate, liver function tests and mental status because chlordiazepoxide (Librium) is a benzodiazepine that can cause respiratory depression, hypotension, hepatic impairment and sedation.The nurse should also monitor for signs of withdrawal such as anxiety, tremors, seizures and delirium.

Choice D is wrong because blood glucose level is not affected by chlordiazepoxide or alcohol withdrawal.Blood glucose level is more relevant for clients who have diabetes or are taking medications that alter glucose metabolism.

Normal ranges for blood pressure are 90/60 mmHg to 120/80 mmHg, for respiratory rate are 12 to 20 breaths per minute, for liver function tests are AST 10 to 40 U/L, ALT 7 to 56 U/L, ALP 45 to 115 U/L, bilirubin 0.1 to 1.2 mg/dL and for mental status are alert and oriented to person, place, time and situation.