In the ICU, a female client overdosed on Ambien CR. Which intervention is priority?

In the ICU, a female client overdosed on Ambien CR. Which intervention is priority?

• A. Refer the client to a psychiatric nurse practitioner.
• B. Allow the client to ventilate her feelings.
• C. Administer 1.5 L of Go-Lytely, a whole bowel irrigation.
• D. Ensure the client turns, coughs, and deep-breathes every 2 hours.

Answer: (C)

When a sustained‑release medication is overdosed, the priority is to limit further absorption by removing the drug from the GI tract. Ambien CR releases zolpidem over time, so if a significant number of extended‑release tablets were ingested, GI decontamination to hasten elimination becomes the most effective way to reduce ongoing toxicity. Whole bowel irrigation with a polyethylene glycol solution like GoLYTELY flushes the entire bowel and physically clears intact tablets, speeding removal of the remaining drug and limiting further absorption. This approach directly addresses the toxin load and can shorten the duration of central nervous system depression. Other options don’t reduce the toxin burden: addressing emotional issues or encouraging coughing and deep breathing won’t stop more drug from being absorbed, and while airway protection is always important, the intervention that most directly lowers drug absorption here is whole bowel irrigation.

When a sustained‑release medication is overdosed, the priority is to limit further absorption by removing the drug from the GI tract. Ambien CR releases zolpidem over time, so if a significant number of extended‑release tablets were ingested, GI decontamination to hasten elimination becomes the most effective way to reduce ongoing toxicity. Whole bowel irrigation with a polyethylene glycol solution like GoLYTELY flushes the entire bowel and physically clears intact tablets, speeding removal of the remaining drug and limiting further absorption. This approach directly addresses the toxin load and can shorten the duration of central nervous system depression. Other options don’t reduce the toxin burden: addressing emotional issues or encouraging coughing and deep breathing won’t stop more drug from being absorbed, and while airway protection is always important, the intervention that most directly lowers drug absorption here is whole bowel irrigation.