prepU ch 23 Anti-seizure Agents

The nurse has been educating the client on the self-administration of phenytoin. Which statement made by the client demonstrates an understanding of the medication?

"I'll make sure to take the drug with food."

A client has been diagnosed with partial seizures and has been prescribed carbamazepine. When providing health education about the safe and effective use of this medication, what should the nurse teach the client?

"It's safest if you avoid drinking alcohol while you're taking this drug."

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."

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?

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

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

12 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?

2 mcg/mL

A nurse who gives care on a neurological floor is working with several clients. Which client should the nurse prioritize for further assessment and possible interventions?

A client receiving pregabalin who is not responsive to verbal stimuli

The neurological nurse cares for several clients who have seizure disorders. Which client should the nurse monitor most closely for indications of drug dependence?

A client with a history of tonic-clonic seizures who takes phenobarbital

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

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 mostappropriate intervention based on the assessment of the client's symptoms and laboratory results?

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

A nurse is caring for a patient who is going to take ethosuximide. During the nurse's initial assessment, the nurse learns that the patient's history includes hepatitis. Which laboratory test should be done before therapy is started?

Alanine aminotransferase (ALT)

A nurse should monitor a client closely for increased CNS depressant effects when an anticonvulsant is used concomitantly with which substances? (Select all that apply.)

Analgesics Alcohol

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?

Anticipate a reduction in dosage

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 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?

Bone marrow depression

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

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

Consult with the primary health care provider.

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.

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?

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

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

Depression of motor nerve output

The client is prescribed an anticonvulsant medication. After administering the medication, the nurse should monitor for which adverse reactions? Select all that apply.

Drowsiness Ataxia Urticaria Gingival hyperplasia

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

Drug-drug interactions

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

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?

Ethosuximide

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?

Falls

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

A 7-year-old child with epilepsy takes phenytoin for the control of seizures. What oral assessment does the nurse make related to a common side effect of the medication?

Gingival hyperplasia

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

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

Inhibition of impulse conduction

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. The client is experiencing continuous seizure activity without any interruptions. Which anticonvulsant would the nurse anticipate that the primary health care provider would most likely prescribe initially?

Lorazepam

A client is to receive ethotoin. The nurse would expect to administer this drug by which route?

Oral

After teaching a group of nursing students about seizures, the instructor determines that the teaching was successful when the group identifies seizures that do not impair consciousness but can involve the senses or motor ability as which type?

Partial seizures

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?

Rapid rhythmic and symmetric jerking movements

The nurse has taught a client who is receiving lamotrigine about possible adverse effects. The nurse determines that the client has understood the teaching when the client identifies a need to promptly report what adverse effect?

Rash

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.

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?

Risk for Falls

The nurse is caring for a client who has taken hydantoins for several years. The nurse noted that the client has an unsteady gait, dizziness, nystagmus, acute confusion, and a nonraised red rash on one arm and has not been to the dentist for 2 years. Based upon the findings, what is the priority nursing diagnosis?

Risk for injury related to untoward effect of hydantoin

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?

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?

Status epilepticus

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.

The nurse understands that certain classifications of drugs may be used to treat more than one condition and knows that what medication may be used for both bipolar and seizure disorders?

Valproic acid

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.

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

abruptly stopping the antiseizure medications

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

aura

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

gabapentin

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

oral

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:

renal impairment.

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.

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?

skin rash

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

status epilepticus

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.