Sedative-Hypnotic Therapy
Nursing Process•   Assessment:•   CNS—identify level of alertness and orientation•   Vital sign—obtain BP, HR, RR•   Sleep...
Nursing Diagnoses•   Disturbed sleep pattern•   Readiness for enhanced sleep•   Risk for injury (adverse effects)•   Defic...
Nursing Process: Planning• CNS function   – schedule assessments & monitoring vital signs at least Q8hr• Sleep Pattern   –...
Nursing Process: Implementation• Obtain vital sign periodically• Give preoperative medication at specific time• Monitoring...
Nursing Process: Implementation•   Patient Education & Health Promotion•   Bedtime – standard time to go to bed•   Nutriti...
Sedative Hypnotic• Barbiturates• Benzodiazepine• Non-Barbiturates, Non-Benzodiazepine
Barbiturates• Reversibly depress the activity of all excitable  tissue• Used rarely limited to 2 weeks• Amobarbital !• But...
Benzodiazepines• Serve as    –   Anticonvulsants    –   Antianxiety    –   Muscle relaxants    –   Sedative hypnotics•   E...
Miscellaneous Sedative Hypnotics• CNS depression• Types:   –   Histamine-1 blockers (antihistamines)   –   Melatonin Recep...
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Sedative hypnotic therapy

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Sedative hypnotic therapy

  1. 1. Sedative-Hypnotic Therapy
  2. 2. Nursing Process• Assessment:• CNS—identify level of alertness and orientation• Vital sign—obtain BP, HR, RR• Sleep pattern—usual pattern, disturbances, amt. of hours, regular time to go to bed• Anxiety level—need listening, stressors• Environmental control—sleep interferences• Nutritional needs—dietary history (caffeinated especially• Alcohol intake—cause sedation, disrupts sleep, cause early- morning awaking• Exercise—degree of physical activity & what times of day• Respiratory status--snoring
  3. 3. Nursing Diagnoses• Disturbed sleep pattern• Readiness for enhanced sleep• Risk for injury (adverse effects)• Deficient knowledge related to meds• Insomnia• Sleep deprivation
  4. 4. Nursing Process: Planning• CNS function – schedule assessments & monitoring vital signs at least Q8hr• Sleep Pattern – Usually ordered PRN – Never leave at bedside – Reassess cause of sleeplessness• Anxiety level – Be aware of paradoxical response• Environmental control – Safety needs—call light, bed in low position, side rails up, leave nightlight on, less disturbances• Nutrition – Offer protein & diary product before sleep• Exercise during the day
  5. 5. Nursing Process: Implementation• Obtain vital sign periodically• Give preoperative medication at specific time• Monitoring effects (therapeutic & adverse reactions)• PRN assess and record effectiveness
  6. 6. Nursing Process: Implementation• Patient Education & Health Promotion• Bedtime – standard time to go to bed• Nutrition – food plate, fluid intake, vitamin use, avoid heavy meal late in evening, alcohol & caffeine consumption reduced or discontinued, introduce decaffeinated or herbal products, dairy & protein products• Personal comfort – position, back rub, empty bladder, calm fears• Environmental control – quiet, darkened room, less distraction, no TV, adequate ventilation, subdued lighting, correct temperature, control traffic, nightlight• Activity & Exercise – include in daily activities• Stress management –counseling, relaxation techniques, referrals for mastery of biofeedback, meditation, express feelings, channeling toward positive realistic goals• Fostering health maintenance –discuss med, how it benefits, stress non- pharmacologic interventions, compliance, provide significant other information, adverse effects and serious adv. Effects• Written Record –record of monitoring parameters, assess understanding, follow up visit
  7. 7. Sedative Hypnotic• Barbiturates• Benzodiazepine• Non-Barbiturates, Non-Benzodiazepine
  8. 8. Barbiturates• Reversibly depress the activity of all excitable tissue• Used rarely limited to 2 weeks• Amobarbital !• Butabarbital• Mephobarbital• Pentaobarbital !• Phenobarbital !• Secobarbital
  9. 9. Benzodiazepines• Serve as – Anticonvulsants – Antianxiety – Muscle relaxants – Sedative hypnotics• Estazolam• Flurazepam• Lorazepam• Midazolam• Quazepam• Temazepam• Triazolam
  10. 10. Miscellaneous Sedative Hypnotics• CNS depression• Types: – Histamine-1 blockers (antihistamines) – Melatonin Receptors Stimulant – Valerian – Benzodiazepine Receptor Agonist• Drugs: – Chloral hydrate – Dexmedetomidine – Diphenhydramine – Doxylamine – Eszopiclone – Melatonin – Ramelteon – Valerian – Zalepion – Ziopidem

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