Pharmacology Psych Meds #6

Question

The nurse is caring for a patient admitted with alcohol withdrawal. The patient’s vital signs change from 120/62 mm Hg and pulse of 84 to 168/92 mm Hg and pulse of 110. Which action will the nurse perform next?

Answers

  1. Administer atenolol
    • Rationale:

      This answer is not correct because the underlying problem is not addressed, which is the CNS irritability associated with alcohol withdrawal. Atenolol is a beta blocker and it would lower the blood pressure and reduce some anxiety, but would not be as effective as lorazepam in managing the CNS irritability. Lorazepam’s anxiolytic effects will help decrease anxiety, blood pressure, and heart rate, as well as the general CNS irritability that is associated with alcohol withdrawal.

  2. Administer lorazepam
    • Rationale:

      This answer is correct because lorazepam is a benzodiazepine medication that provides a sedative effect. This is especially useful for the patient with central nervous system irritability from alcohol withdrawal. Symptoms associated with alcohol withdrawal includes increased blood pressure, heart rate, tremors, anxiety, hallucinations, and seizures. The patient should be monitored carefully during this time and after the sedative is administered to assure the patient does not have too much sedation.

  3. Administer potassium
    • Rationale:

      This answer is not correct because there is nothing indicated the patient has decreased potassium levels. If potassium is given and the patient does not need potassium, an elevated potassium could produce a cardiac arrhythmia.

  4. Administer sodium
    • Rationale:

      This answer is not correct because there is nothing indicated the patient has decreased sodium levels. If sodium is given and the patient does not need sodium, an elevated sodium could produce additional increase in heart rate, altered level of consciousness, and CNS irritability.

Overview

Alcohol withdrawal symptoms include increased blood pressure, heart rate, tremors, anxiety, hallucinations, and seizures. Lorazepam is a sedative used to treat the symptoms associated with alcohol withdrawal.

Explanation

The correct answer is B because lorazepam will help decrease symptoms of CNS irritability with early alcohol withdrawal symptoms. Selection A is incorrect. Although the client is hypertensive, administering the anti-hypertensive drug will not treat the CNS irritability (which is the underlying problem). Selections C and D are incorrect since potassium and sodium are not the reasons for the changes in vital signs.

Learning Outcomes

Lorazepam is a benzodiazepine medication that provides a sedative effect. This is especially useful for the patient with central nervous system irritability from alcohol withdrawal. Symptoms associated with alcohol withdrawal includes increased blood pressure, heart rate, tremors, anxiety, hallucinations, and seizures. The patient should be monitored carefully during this time and after the sedative is administered to assure the patient does not have too much sedation.

Test Taking Tip

Try to not to read things into the question. If there is no indication of something specifically occurring, do not add to the question because it could be occurring. Stay with the facts and what those facts point to, but nothing else.

Video Rationale