The nurse prepares prescribed IV lorazepam for an adult with… | MyMerci
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Adverse Effects/Contraindications/InteractionsPPT
Question
The nurse prepares prescribed IV lorazepam for an adult with status epilepticus. Which administration action is appropriate?
1Dilute it as directed, give no faster than 2 mg/min, and continuously monitor airway and respirations.✓ Correct answer
2Give it as a rapid IV push to stop the seizure, then assess respirations after the seizure ends.
3Use the intramuscular route despite patent IV access, then wait 15 minutes before assessing the airway.
4Mix it with an opioid in one syringe to deepen sedation, then monitor the pulse without ventilation equipment.
Explanation
For adult status epilepticus, IV lorazepam is administered slowly at a rate no faster than 2 mg/min after product-specific dilution. Respiratory depression is the most important risk, so airway patency, respirations, oxygenation, and vital signs require close monitoring with ventilation equipment available. Rapid IV administration, delaying airway assessment, or mixing lorazepam with an opioid creates avoidable respiratory danger.
Clinical reasoning Lorazepam can terminate seizure activity but can also depress ventilation and compound postictal impairment of consciousness. Slow administration and airway readiness must occur together.
Decision rule For IV lorazepam in adult status epilepticus, do not exceed 2 mg/min and maintain continuous respiratory assessment with ventilatory support immediately available.
Clinical scenario
Scenario A 56-year-old male was admitted 48 hours ago for alcohol use disorder withdrawal. CIWA-Ar 28 and a 90-second generalized tonic-clonic seizure just occurred. The provider orders lorazepam 2 mg IV push now. The client has a patent 20-gauge peripheral IV in the left forearm and pulse oximetry of 96% on room air.
Key concepts
IV lorazepam rate — The injection rate should not exceed 2 mg/min; product-specific dilution instructions must also be followed.
Benzodiazepine respiratory depression — Lorazepam can suppress ventilation, requiring airway patency, close respiratory monitoring, and immediate access to ventilatory support.
Flumazenil — A benzodiazepine antagonist used to reverse iatrogenic respiratory depression; not given prophylactically because it can precipitate seizures in chronic benzodiazepine users.