Edited Text
A client with generalized anxiety disorder (GAD) receives a new prescription for lorazepam. Which statement provided by the client requires additional instruction by the nurse?
Use relaxation techniques to reduce excessive anxiety.
Avoid alcohol and other sedatives while taking the medication.
Move slowly from a sitting position to a standing position.
Stop taking the medication if intended effect is not immediate.
The Correct Answer is D
The correct answer is d. Stop taking the medication if intended effect is not immediate.
Choice A Reason:
Using relaxation techniques to reduce excessive anxiety is a beneficial practice for managing generalized anxiety disorder (GAD). Techniques such as deep breathing, meditation, and progressive muscle relaxation can complement medication therapy and help reduce anxiety symptoms1. This statement does not require additional instruction as it aligns with recommended practices.
Choice B Reason:
Avoiding alcohol and other sedatives while taking lorazepam is crucial. Lorazepam is a benzodiazepine that can cause sedation and depress the central nervous system. Combining it with alcohol or other sedatives can enhance these effects, leading to dangerous levels of sedation, respiratory depression, or even overdose2. This advice is appropriate and does not need further instruction.
Choice C Reason:
Moving slowly from a sitting position to a standing position is important to prevent dizziness or lightheadedness, which can be side effects of lorazepam3. This precaution helps reduce the risk of falls and injuries, making it a suitable recommendation that does not require additional instruction.
Choice D Reason:
Stopping the medication if the intended effect is not immediate requires additional instruction. Lorazepam, like other benzodiazepines, may not produce immediate effects, especially in the context of anxiety management. It is important for clients to understand that medication may take some time to achieve the desired therapeutic effect and that abrupt discontinuation can lead to withdrawal symptoms and a potential rebound in anxiety4. The nurse should instruct the client to follow the prescribed regimen and consult their healthcare provider before making any changes to their medication.
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Related Questions
Correct Answer is B
Explanation
Choice A reason:
Performing a bladder scan is useful for assessing urinary retention, which can be a symptom of benign prostatic hyperplasia (BPH). However, it is not the primary method for monitoring adverse reactions to tamsulosin. Tamsulosin is an alpha-1 blocker that relaxes the muscles in the prostate and bladder neck, improving urine flow. While it can help reduce urinary retention, the primary concern with tamsulosin is its effect on blood pressure.
Choice B reason:
Monitoring blood pressure is crucial because tamsulosin can cause orthostatic hypotension, a condition where blood pressure drops significantly when a person stands up from a sitting or lying position. This can lead to dizziness, lightheadedness, and even fainting. Regular monitoring of blood pressure helps detect and manage this potential adverse reaction, ensuring the client’s safety.
Choice C reason:
Obtaining daily weights is important for monitoring fluid balance and detecting conditions like heart failure or kidney disease. However, it is not directly related to the adverse reactions of tamsulosin. The primary concern with tamsulosin is its impact on blood pressure, not fluid retention.
Choice D reason:
Assessing urine output is important for evaluating the effectiveness of tamsulosin in relieving urinary symptoms associated with BPH. However, it is not the primary method for monitoring adverse reactions. The main adverse reaction to be aware of with tamsulosin is its potential to cause orthostatic hypotension, making blood pressure monitoring the priority.
Correct Answer is C
Explanation
Choice A Reason:
Checking for the correct placement of the patch behind the client’s ear is important to ensure proper administration of the medication. However, this action does not address the client’s concern about pain relief. Scopolamine is used to prevent nausea and vomiting, not to manage pain. Therefore, while correct placement is necessary, it does not explain why the client is still experiencing pain.
Choice B Reason:
Offering to apply a new transdermal patch to relieve the pain is not appropriate because scopolamine is not intended for pain relief. Applying a new patch would not address the client’s pain and could lead to unnecessary medication use. The nurse should clarify the purpose of the medication instead.
Choice C Reason:
Explaining that the medication is not given to prevent pain is the correct action. Scopolamine is an anticholinergic medication used to prevent nausea and vomiting associated with motion sickness and recovery from anesthesia. It is not an analgesic and does not provide pain relief. The nurse should inform the client about the intended use of the medication and address pain management separately.
Choice D Reason:
Advising the client that the effects of the medication have worn off is incorrect. Scopolamine patches are designed to release medication over a period of up to 72 hours. The effects would not wear off within a few hours. This statement does not address the client’s misunderstanding about the purpose of the medication.
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