Chapter 28: antiepileptics

One week ago, a client began taking ethosuximide 500 mg/day PO for the treatment of absence seizures. The client reports gastrointestinal (GI) upset after taking with the drug. What health education should the nurse provide?

"Try taking your pills at the same time as you eat some food."

Kate is experiencing status epilepticus. The prescriber orders IV diazepam. What special precautions need to be taken by a nurse to administer IV diazepam?

Administer the drug very slowly, no faster than 5 mg/min.

A client has been admitted to the emergency department and is experiencing tonic-clonic seizures. What intervention should the nurse prioritize?

Administration of phenytoin IV as prescribed

A client diagnosed with a left temporal brain tumor reports an odor of ammonia just prior to experiencing rapid rhythmic jerking movements. What is the odor of ammonia classified as?

An aura prior to the seizure activity

A client who has been taking medication for a seizure disorder is asking the nurse about getting pregnant. Why is pregnancy discouraged in women who are being treated for seizure disorders?

Antiepilepsy drugs are teratogenic.

A nurse is caring for a hospital client who has just been prescribed phenytoin for a seizure disorder. What assessment should the nurse prioritize when assessing for adverse effects?

Assessment of level of consciousness

The nurse is documenting the history of a client who is starting anticonvulsant therapy with carbamazepine. The nurse reviews the client's medical record for possible conditions contraindicating the drug's use. Which, if found, would lead the nurse to notify the primary health care provider?

Bone marrow depression

The nurse has administered gabapentin to a client. Following administration, the nurse should assess the client for what possible adverse effect?

Central nervous system (CNS) depression

A client is prescribed lamotrigine for control of partial seizures. What is the most important medication teaching information the nurse should emphasize from the plan of care?

Contact the health care provider immediately if rash appears.

What medication may be administered intravenously (IV) to assist in reducing status epilepticus seizure activity?

Diazepam

A nurse is caring for a patient who has been prescribed miscellaneous anticonvulsants containing valproic acid. What method of drug administration should the nurse inform the patient about?

Do not chew but swallow the whole tablet to avoid irritation

The nurse evaluates the client's latest serum phenytoin level which is revealed to be 16 mcg/mL. What is the nurse's best action?

Document the fact that the client's phenytoin level is therapeutic.

The nurse is reviewing the results of a hospital client's serum phenytoin level, which has just become available. The results indicate that the client's phenytoin level is 17.5 mcg/mL. What is the nurse's best action?

Document the fact that the nurse checked the client's phenytoin levels

A client has been prescribed carbamazepine for the prevention of seizures. What action should the nurse perform?

Educate the client about the need to take the pills as scheduled

When reviewing a journal article about seizure disorders, the nurse would expect to find tonic-clonic seizures and myoclonic seizures being classified as which type of seizures?

Generalized seizures

The nurse is preparing to administer phenytoin (Dilantin) to a client. The nurse should notify the healthcare provider before administration based on which assessment finding?

Heart rate 50 beats per minute on cardiac monitor.

An older adult client has been prescribed an antiseizure medication and is experiencing central nervous system depression. What is the nurse's most appropriate action?

Implement falls precautions

The nurse is formulating a care plan for a client with a seizure disorder. Which intervention would be an appropriate for the nurse to include?

Informing the client and family that seizure control is not gained immediately

What should the nurse include as a possible adverse effect when teaching a client about phenytoin?

Liver toxicity

A client comes to the emergency department experiencing status epilepticus. Which medication would the nurse expect to administer?

Lorazepam

A client is experiencing status epilepticus. Which medication should the nurse prepare to administer?

Lorazepam (Ativan)

A client is prescribed methsuximide. The nurse should expect to administer this drug by which route?

Oral

While taking the vital signs of a hospitalized client admitted for seizure control due to epilepsy, the nurse notices a bloody toothbrush on the client's bedside table and scattered bruising over the client's extremities. What is the nurse's best action?

Report the findings to the primary health care provider immediately

Which nursing diagnosis would be most important for a nurse to include in the plan of care for a client who is receiving an antiseizure agent and experiencing common adverse effects?

Risk for injury

The nurse is participating in the care of a client in status epilepticus who is receiving phenobarbital IV. Which nursing diagnosis should the nurse prioritize during this client's current care?

Risk for injury related to seizure activity

A client prescribed phenytoin for a seizure disorder has recently run out of medication and has not obtained a refill. What is the client at risk for developing?

Status epilepticus

The nurse has witnessed a client having a seizure. What is the nurse's initial action?

Take and document the vital signs of the client

A client with a history of partial seizures has been taking lamotrigine for the past several days. The client calls the clinic and reports the development of a facial and torso rash to the nurse. What is the nurse's best action?

Tell the client to take no further doses and come be assessed at the clinic immediately.

A client is prescribed topiramate. The nurse cautions the client to avoid the intake of alcohol for which reason?

The client is at risk for increased CNS depression

A client has a new diagnosis of a seizure disorder. What aspect of this client's health status would contraindicate the use of carbamazepine?

The client's most recent blood work reveals pancytopenia.

A client, newly diagnosed with a seizure disorder, asks the nurse why the client is receiving a specific drug. What would be the best answer by the nurse?

When prescribing an AED, the health care provider takes into account the type of seizure the client is having

A client, newly diagnosed with a seizure disorder, has been prescribed valproic acid. When assessing for adverse effects, what assessment should the nurse prioritize?

monitoring the client's liver enzyme levels

The nurse is providing client education for a client newly prescribed a hydantoin antiseizure medication. The nurse has taught the client about the need to taper down the dose of the drug slowly when the provider decides it should be discontinued. What benefit of tapering should the nurse describe

reduced risk of status epilepticus

The nurse is caring for a 26-year-old client with partial seizures and has been prescribed oxcarbazepine as monotherapy. It will be critical for the nurse to inform the client of which needed action?

since she is taking oral contraceptives, she will need to use an additional form of birth control.

An adolescent taking oral contraceptives has been prescribed an anticonvulsant medication. The nurse should tell the client to do which?

use another form of birth control, such as condoms.