Pharmacology Chapter 23

Rapid rhythmic and symmetric jerking movements

A 15-year-old is observed having a tonic-clonic seizure at school. Which behavior would allow the school nurse to recognize the clonic phase of the seizure?

"I will make sure he has routine visits to the dentist."

A 15-year-old male client receiving phenytoin for treatment of epilepsy is being discharged from the hospital. What statement by Richard's mother leads you to believe she has understood your teaching related to his care and drug administration?

Risk for Falls

A 77-year-old client is being admitted to a long-term care facility. The client has a history of absence seizures has been treated with ethosuximide for many years. While the nurse is creating a plan of care on the client, the nurse understands the potential adverse effects of this drug and would consequently prioritize which nursing diagnoses?

Ethosuximide

A child has been presented for care because he has episodes where he pauses what he is doing for a few seconds, is unresponsive, and then continues on with his activity. The nurse should anticipate the administration of what medication?

Avoid ginkgo supplements

A client has a history of seizures of which the client takes phenytoin on a regular basis. What should the nurse teach the client in order to ensure safety?

Administration of phenytoin IV as prescribed

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

Liver enzymes

A client has been prescribed valproic acid for the treatment of myoclonic seizures. When reviewing this client's latest laboratory results for signs of adverse effects, what results should the nurse prioritize?

Consult with the primary health care provider.

A client in the clinic with a history of epilepsy has just tested positive for pregnancy. What is the nurse's next action?

Carbamazepine

A client is diagnosed with trigeminal neuralgia. What antiepileptic agent may be used to treat this disorder?

Contact the health care provider immediately if rash appears.

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?

Oral

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

Anticipate a reduction is dosage

A client is receiving carbamazepine therapy and the client's latest serum level of the drug is 13 mcg/mL. What action is most appropriate?

Rash

A client is receiving lamotrigine as treatment for partial seizures. Which assessment finding would lead the nurse to stop the drug immediately?

aura

A client reports sensing an unusual smell just prior to experiencing a tonic-clonic seizure. What term is used to describe this event?

Antiepilepsy drugs are teratogenic.

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?

Safety precautions

A client who is receiving an antiseizure agent reports feeling sleepy and tired and reports dizziness when standing up. Which intervention would the nurse most likely implement as the priority?

12 mcg/mL

A client who is receiving phenytoin has a serum drug level drawn. Which result would the nurse interpret as within the therapeutic range?

"They are considered teratogenic."

A female client's seizure disorder has been successfully controlled by AEDs for years. She and her husband decide that it is time to start a family. She asks the nurse if it is safe for the fetus for her to continue her AEDs as prescribed. What is the nurse's best response?

renal impairment.

A nurse is caring for a client with trigeminal neuralgia at a health care facility. The health care provider has prescribed carbamazepine. In which case is the use of carbamazepine contraindicated in clients with:

Slurred speech

A nurse is caring for a patient administered ethotoin. What are signs of toxicity for which the nurse should monitor the patient?

Observe respirations frequently.

A nurse is caring for a patient prescribed phenobarbital for status epilepticus. What intervention should the nurse perform when the patient has been administered the drug?

Trimethadione

A nurse is to administer an anticonvulsant drug. The nurse understands that this drug is classified as an oxazolidinedione. Which drug would the nurse most likely be preparing to administer?

Bone marrow depression

A nurse is treating a patient who is receiving carbamazepine for a seizure disorder. The nurse knows that carbamazepine is contraindicated in patients with which diseases or disorders?

Status epilepticus

A patient is prescribed daily doses of phenytoin for seizures. The nurse knows that a single dose should not be missed during the course of treatment. Which condition could result if a dose is missed?

Assess for adverse effects

A patient with a seizure disorder has had a recent change in medication ordered. In evaluating the new drug's control of the seizure disorder, what would the nurse do?

CNS depression

A patient with cortical focal seizures has been prescribed phenobarbital. What adverse reaction should the nurse monitor for in the patient?

Ethosuximide

After teaching a class on drug classes used to treat seizures, the instructor determines that the teaching has been successful when the students identify which drug as most commonly used in the treatment of absence seizures?

Valproic acid

After teaching a group of students about anticonvulsant therapy, the instructor determines that the teaching was successful when the group identifies which drug as eliciting its effects by increasing levels of gamma-aminobutyric acid (GABA), which stabilizes cell membranes?

Advise the client to have his blood redrawn today to ensure that it is not at a toxic level.

An 18-year-old client has been taking phenytoin for the past 6 months for epileptic seizures. The client's phenytoin levels routinely fall within the therapeutic range. The client contacts the health care provider reporting nausea, headache, and diarrhea. What would be the most appropriate intervention based on the assessment of the client's symptoms and laboratory results?

Implement falls precautions

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?

abruptly stopping the antiseizure medications

In a person being treated for a diagnosed seizure disorder, what is the most common cause of status epilepticus?

febrile seizures.

In children, the most common form of seizure is:

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

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?

Intravenous

Phenobarbital is ordered for a child with status epilepticus. The nurse would anticipate administering this drug by which route?

Ensuring that the client makes the appointments for serum drug levels

The community health nurse also assists the health care provider in the decision-making process for AED drug titration by performing which function?

Febrile seizure

The most common form of epilepsy in children is characterized by what type of seizure?

Central nervous system (CNS) depression

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

5 minutes

The nurse has just begun administering phenobarbital intravenously to a child within status epilepticus. The nurse would expect this drug to begin working within which time frame?

Decreases the sodium influx into the cell, thereby preventing the cell from producing a stimulus

The nurse is caring for a 15-year-old male who was involved in a motor vehicle accident and, as a result, sustained a closed head injury. The health care provider ordered phenytoin prophylactically to prevent seizures. The nurse understands that phenytoin works by what mechanism?

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

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?

Provide lorazepam IVP.

The nurse is caring for a client in the emergency department who is experiencing status epilepticus. The client's electronic medical record reveals a recent diagnosis of tonic clonic seizures and prescription for phenytoin. Which is the priority action?

Falls

The nurse is caring for an 84-year-old client who is taking an AED and recognizes that this client is at increased risk for which condition?

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

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?

2 mcg/mL

The nurse is monitoring the serum carbamazepine level of a client. Which result would lead the nurse to notify the prescriber that the client most likely needs an increased dosage?

Risk for injury related to seizure activity

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?

"You likely won't be able to until your seizures are controlled by medication"

The nurse is providing client teaching with a client who is newly diagnosed with epilepsy. The client asks, "Can I still drive to work?" What is the nurse's best response?

skin rash

The nurse is providing education to an adult client who has been prescribed lamotrigine for a seizure disorder. The nurse should inform the client that the medication must be stopped if what unexpected reaction develops?

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

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?

Status epilepticus

The nurse is teaching a client who has been started on antiseizure medications. The nurse should inform the client that abrupt withdrawal from the medications can cause which problem?

Alterations in consciousness that last seconds

The school nurse sees a child who has had an absence seizure. Which characteristics are typical of this type of seizure?

Inhibition of impulse conduction

What best reflects the action of barbiturates when used to control seizures?

fever

What is a common risk for epileptic seizures during late infancy to early childhood?

gabapentin

What is the primary medication prescribed to relieve pain associated with shingles?

It controls fluid secretion in the central nervous system (CNS).

What is the therapeutic action of acetazolamide?

Diazepam

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

status epilepticus

What type of seizure activity is characterized by generalized tonic-clonic convulsions lasting for several minutes during which the client does not regain consciousness?

Drug-drug interactions

When combination therapy is ineffective, what needs to be reassessed?

Depression of motor nerve output

When describing the action of barbiturates and barbiturate-like agents in the control of seizures, what would the nurse include?

Inhibition of sodium and calcium channels

When describing the action of zonisamide, which would the nurse include?

Generalized seizures

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

Which type of seizures involves a loss of consciousness?

Report the findings to the primary health care provider immediately.

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?