Shortly after admission to an acute care facility, a male client with a seizure disorder develops status epilepticus. The physician orders diazepam (Valium) 10 mg I.V. stat. How soon can the nurse administer the second dose of diazepam, if needed and prescribed?
A. In 30 to 45 seconds
B. In 10 to 15 minutes
C. In 30 to 45 minutes
D. In 1 to 2 hours
Correct Answer: B. In 10 to 15 minutes
When used to treat status epilepticus, diazepam may be given every 10 to 15 minutes, as needed, to a maximum dose of 30 mg. The nurse can repeat the regimen in 2 to 4 hours, if necessary, but the total dose shouldn’t exceed 100 mg in 24 hours. It is crucial to monitor respiratory and cardiovascular status, blood pressure, heart rate, and symptoms of anxiety in patients taking diazepam.
Option A: The nurse must not administer I.V. diazepam faster than 5 mg/minute. Therefore, the dose can’t be repeated in 30 to 45 seconds because the first dose wouldn’t have been administered completely by that time. 0.15 to 0.20 mg/kg IV per dose, and may be repeated once if needed. Do not exceed 10 mg per single dose. Rectal administration of 0.2 to 0.5 mg/kg administered one time. Do not exceed 20 mg per dose.
Option C: Waiting longer than 15 minutes to repeat the dose would increase the client’s risk of complications associated with status epilepticus. When administered intravenously, diazepam actS within 1 to 3 minutes, while oral dosing onset ranges between 15 to 60 minutes. Diazepam is long-lasting with a duration of action of more than 12 hours.
Option D: Diazepam is a fast-acting potent anxiolytic popular in use due to its broad therapeutic index, low toxicity, and improved safety profile. Nonetheless, diazepam is still a drug with high potential for use disorder associated with severe adverse/toxic effects.
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