Nursing Considerations for Patients Receiving Benzodiazepines
苯二氮卓类药使用患者的护理考虑
Assessment: History and Examination评估：病史和检查
• Assess for contraindications or cautions: known allergies to benzodiazepines to prevent hypersensitivity reactions; impaired liver or kidney function, which could alter the metabolism and excretion of a particular drug; any condition that might be exacerbated by the depressant effects of the drugs (e.g., glaucoma, coma, psychoses, shock, acute alcohol intoxication); and pregnancy and lactation.
禁忌症与注意事项评估：苯二氮卓类药的已经过敏，防止超敏反应；肝、肾功能受损，可能改变药物的代谢和排泄；疾病，可能因药物抑制作用而使病情加重（如青光眼、昏迷、精神病、休克、急性酒精中毒）；妊娠和哺乳。
• Assess for baseline status before beginning therapy to check for occurrence of any potential adverse effects. Assess for the following: temperature and weight; skin color and lesions; affect, orientation, reflexes, and vision; pulse, blood pressure, and perfusion; respiratory rate, adventitious sounds, and presence of chronic pulmonary disease; and bowel sounds on abdominal examination.
开始治疗前进行基线状况评估，检查有无出现任何潜在的不良效应。评估有无下列情况：体温和体重；皮肤颜色和病损；情感、定向力、反射和视觉；脉搏、血压、灌注；呼吸率、附加音和慢性肺病；腹部检查肠鸣音。
• Perform laboratory tests, including renal and liver function tests and complete blood count (CBC).
进行实验室检查，包括肾和肝功能试验和全血计数（CBC）。
Nursing Diagnoses 护理诊断
Nursing diagnoses related to drug therapy might include the following:
• Disturbed Thought Processes and Disturbed Sensory Perception (Visual, Kinesthetic) related to CNS effects
• Risk for Injury related to CNS effects
• Disturbed Sleep Pattern related to CNS effects
• Deficient Knowledge regarding drug therapy
与药物治疗相关的护理诊断可能包括：
思维过程混乱和感官知觉紊乱（视觉、动觉），与CNS效应相关
操作风险，与CNS效应相关
睡眠形态紊乱，与CNS效应相关
知识缺乏，与药物疗法相关
Implementation 实施
• Do not administer intra-arterially because serious arteriospasm and gangrene could occur. Monitor injection sites carefully for local reactions to institute treatment as soon as possible. 不得动脉给药，因为可能出现严重的动脉痉挛和坏疽。仔细监测注射部位有无局部反应，尽快进行治疗
• Do not mix intravenous (IV) drugs in solution with any other drugs to avoid potential drug–drug interactions.
不要在静脉药液中混合其他任何药物，避免潜在的药药相互作用
• Give parenteral forms only if oral forms are not feasible or available, and switch to oral forms, which are safer and less likely to cause adverse effects, as soon as possible.
只有在口服剂型不可行或无法得到时使用胃肠外药型，因为口服型更加安全，引起不良效应的可能性更小。尽快改用口服剂型
• Give IV drugs slowly because these agents have been associated with hypotension, bradycardia, and cardiac arrest.
静脉给药速度要慢，因为这些药与低血压、心搏徐缓和心搏骤停存在相关性
★Vocabulary for Today ★
exacerbate – v. 加重，加剧
glaucoma – n. 青光眼
psychoses – n. 重性精神病
intoxication – n. 中毒，毒性
adventitious – a. 偶然的，外来的
adventitious sounds – 附加音
intra-arterially – ad. 动脉内
arteriospasm – n. 动脉痉挛
gangrene – n. 坏疽
1. The nurse is preparing to administer alprazolam to a client who is diagnosed with a generalized anxiety disorder. Which intervention should the nurse implement prior to administering the medication?
A. Assess the client’s apical pulse.
B. Assess the client’s serum potassium level.
C. Assess the client’s anxiety level.
D. Assess the client’s blood pressure. 2. The elderly client being prepared for major abdominal surgery has been taking alprazolam PRN for many years for nerves. Which information should the nurse discuss with the HCP?
A. Discuss prescribing another benzodiazepine medication postoperatively.
B. Make sure that the alprazolam is ordered after surgery.
C. Taper the medication to prevent complications.
D. Change the alprazolam to a medication for sleep.
答案 Key to Questions
1. C. Assess the client’s anxiety level
The nurse must assess the client’s anxiety level on a scale of 1 to 10, with 10 being the most anxious, before administering the benzodiazepine alprazolam (Xanax). If the nurse does not do this, there is no way to evaluate the effectiveness of the medication later. 2. A. Discuss prescribing another benzodiazepine medication postoperatively
The client is having abdominal surgery, so the client will be NPO for a while. Alprazolam (Xanax), a benzodiazepine, is only manufactured as an oral medication; therefore, the client will need a similar medication postoperatively. The nurse should discuss this with the HCP.
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