Chapter 22 anticonvulsants
a client is receiving phenytoin IV for seizure disorder. after several days of IV, the nurse notices that the insertion site is red and swollen. whats the best action by the nurse? A) discontinue the medication and request that the client be changed to an oral dose B) continue the medication infusion and monitor the IV site more frequently C) flush the IV with normal saline and continue the current infusing D) discontinue this IV infusion, restart the IV in another site and restart the infusion.
D
as a result of a clients long-term use of phenytoin, which lab test would the nurse want ordered for the client? A) serum potassium (K) B) serum BUN and creatinine C) platelet count D) serum blood glucose
D
the client has not responded to other anticonvulsant drug therapy. which drug would expect to be prescribed for this client? A) diazepam B) valproic acid C) ethosuximide D) carbamazepine
D
client who had been receiving phenytoin for a seizure disorder will be discharged in a couple of days. the nurse is preparing for discharge teaching. what information about side effects of this medication should the client receive? A) the client may have a permanent brown discoloration of her urine B) the client should brush her teeth with a firm toothbrush C) the client may experience nosebleeds and a sore throat D the client may experience orthostatic hypotension
C
A client who is to begin taking oral phenytoin for a seizure disorder asks how long she will need the medications. what is the nurses best response to this question? A) you will need to take this medication for a lifetime B) this medication should be taken until you are seizure-free C) unfortunately, seizures are unpredictable, and therefore so is the drug regimen D) for a short period of time, as seizure disorders are cured by medications
A
The client is diagnosed with status epilepticus. which medication would the nurse expect to be prescribed? A) diazepam B) primidone C) acetazolamide D) valproic acid
A
a client who has been receiving phenytoin IV for a seizure disorder has been changed to an oral medication. which order for oral administration should the nurse question? A) 100 mg PO daily B) 100 mg PO tid C) 100 mg PO bid D) all of the above
A
the client has just found out she is pregnant and is in need of seizure medications. which medication has been shown to be teratogenic and should not be given to a pregnant client? A) phenytoin B) valproic acid C) anticonvulasants D) trimethadione
A
the nurse is conduction an admission assessment for a client who had been taking phenytoin for 20 yrs. the client has not reported any seizure activity while taking the maintenance dose. what would the nurse expect to see if this client is experiencing a common side effect of the drug? A) gingival hyperplasia B) polyuria C) weight gain D( irritability
A
Which statement is/are true about seizures and anticonvulant use during pregnancy? (select all) A) seizures increase 25 % in epileptic women B) many anticonvulasants have teratogenic properties C) anticonvulsant use increases loss of folic acid D) anticonvulants increase the effects of Vitamin K E) valproic acid causes major malformations in 40-80% of fetuses
ABC
a client is receiving anticonvulasant medication and many other medicaitons. which type of drugs should the nurse question before administration? (select all) A) digoxin B) antineoplastic C) sulfonamides D) laxatives
ABC
The nurse assesses the client for side effects of phenytoin. what clinical manifestations might the nurse see? (select all) A) nausea B) vomiting C) diarrhea D) headache E) nystagmus FF) gingival hyperplasia
ABD
in the event that a client taking anticonvulsant medication experiences a seizure, what information should be included in the nurse's documentation? (select all) A) type of movements B) time the movements started and ended C) ability to stop the movements D) progression of movements
ABD
The client is receiving phenytoin and asks how this medication works in the body. what is the nurse's best response? A) it inhibits the enzyme that destroys GABA B) it suppress the entry of sodium into the cell C) we are not sure how it works, but it suppresses seizures D) it increases the amount of calcium that enters the cell
B
When a client is taking phenytoin for a seizure disorder, serum phenytoin levels should be monitored to be determine if the blood serum level is within the therapeutic range, thus avoiding toxic levels. which result is within the therapeutic range? A) 5 mcg/mL B) 12 mcg/mL C) 23 mcg/mL D) 42 mcg/mL
B
What should be included in the health teaching plan for the client taking phenytoin (select all) A) restrict fluids while taking phenytoin B) urine may be a harmless pink or reddish brown color C) alcoholic beverages are not recommended D) the drug may have a teratogenic effect on a fetus E) avoid aspirin while taking phenytoin
BCDE
A 24 yr old who has a seizure disorder is going to start taking phenytoin, the drug of choice to control her seizure activity. the client will initially receive IV phenytoin. what should the nurse check before giving this medication? A) urine output B) blood glucose levels C) patency of the client's IV D) dietary intake
C
a client's initial order is to receive phenytoin for a seizure disorder. the nurse is getting ready to administer the next dose and notices that the medication is mixed with a dextrose solution. what is the nurse's best action? A) administer the medication after flushing the IV to assure patency B) administer the medication but decrease the rate of infusion to prevent a reaction C) send the medication back to the pharmacy and request the drug be mixed in a saline solution D) contact the physician and request that the medication be changed to an oral dose
C
