The pre-operative nurse is preparing a patient for coronary bypass graft surgery. The patient has already signed the consent form. The patient is very anxious and has a rapid pulse and is starting to hyperventilate. What is the most appropriate action?

Explanation

• It is common for patients to experience anxiety prior to surgery. These clients will have standing orders for anxiolytic medications to reduce anxiety symptoms, which are the same drugs given after they enter the operating room to relax them for the procedure or prior to intubation.

• It is most appropriate to administer the dose of midazolam IV (a benzodiazepine) now and to inform the anesthesia provider of this in case they do not check the MAR before giving more medication.

• Lorazepam is an effective anxiolytic medication, but it should not be given by mouth (PO) prior to a surgical procedure because it will not take effect quickly enough and the patient will be NPO for the surgery.

• Calling the provider to report anxiety symptoms is not necessary since pre-operative patients already have standing orders for medications to treat anxiety.

• It is not helpful to tell a patient to calm down. This may be interpreted as dismissive.

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