Which of the following is an important nursing action for the administration of a benzodiazepine as a sedative-hypnotic agent?
A. Use IM dosage forms for longer duration.
B. Administer safely with other CNS depressants for insomnia.
C. Monitor geriatric patients for the common occurrence of paradoxical reactions.
D. Evaluate for physical dependence that occurs within 48 hours of beginning the drug.
Correct Answer: C. Monitor geriatric patients for the common occurrence of paradoxical reactions.
Careful monitoring of all vitals, especially blood pressure and respiratory rate, should be performed after the administration of benzodiazepines. Waveform capnography, if available, should be seriously considered to monitor respiratory status.
Option A: Benzodiazepine administration can be performed by providing small doses of the medication until the desired effect (i.e., sedation, cessation of seizure activity, anxiolysis) has been achieved. It should be noted that with intravenous administration, it may take 3 to 5 minutes to achieve a CNS drug concentration adequate to produce the desired effect.
Option B: The FDA strongly reminds providers that extreme care should be taken when administering benzodiazepines with other central nervous system depressants such as alcohol, barbiturates, and opioids.
Option D: Though the therapeutic index of benzodiazepines is high, monitoring of respiratory depression is critical. Respiratory arrest has been noted to occur with rapid injection of benzodiazepines via the intravenous route.
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