A client on long-term high-dose alprazolam admits to abruptly stopping it 36 hours ago. He has tremor, anxiety…

Question

A client on long-term high-dose alprazolam admits to abruptly stopping it 36 hours ago. He has tremor, anxiety, BP 168/98, HR 116, and one witnessed generalized seizure. Which action is the priority?

Accepted Answer

Option 2: Initiate IV long-acting benzodiazepine such as diazepam, then plan a gradual outpatient taper

Abrupt cessation of high-dose long-term benzodiazepines can cause life-threatening withdrawal: seizures, autonomic instability, even delirium. Treatment is substitution with a long-acting BZD (diazepam, chlordiazepoxide) — or phenobarbital in some protocols — at a stabilizing dose followed by gradual taper over weeks to months. Discharge after one dose is unsafe. Haloperidol does NOT prevent BZD withdrawal seizures and may lower seizure threshold. Restraint without pharmacologic management is harmful.

Answer

Option 1: Immediately resume alprazolam at maintenance dose and discharge home

Answer

Option 3: Administer haloperidol IM for agitation and observe

Answer

Option 4: Use cold packs and physical restraint until symptoms resolve

A client on long-term high-dose alprazolam admits to abruptly stopping it 36 hours ago. He has tremor, anxiety, BP 168/98, HR 116, and one witnessed generalized seizure. Which action is the priority?

In-depth explanation

Clinical scenario

Key concepts

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A client on long-term high-dose alprazolam admits to abruptly stopping it 36 hours ago. He has tremor, anxiety, BP 168/98, HR 116, and one witnessed generalized seizure. Which action is the priority?

In-depth explanation

Clinical scenario

Key concepts

Master the NCLEX-RN with MyMerci