Chapter 23: Anti-seizure Agents

A patient is receiving carbamazepine therapy. Which serum drug level result would lead the nurse to suspect that the patient needs a decrease in dosage?

14 mcg/mL

When reviewing the results of a patient's serum phenytoin level, which level would indicate toxicity?

22 mcg/mL

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

5 minutes

In a person taking medications for a diagnosed seizure disorder, the most common cause of status epilepticus is:

Abruptly stopping the antiseizure medications.

While speaking with a client, the nurse notes that the client stares off, unblinking. The nurse notes that after several prompts, the client blinks rapidly and then resumes normal conversation. The type of seizure demonstrated by this client is:

Absence seizure.

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

Alterations in consciousness that last seconds

Your client reports that her seizure was preceded by a brief warning, which she describes as an unusual smell. This is known as:

An aura

Which of the following factors should the clinician reassess when combination therapy is ineffective?

Drug-drug interactions

A child suffers from absence seizures. What is the drug of choice for absence seizures?

Ethosuximide (Zarontin)

Tonic-clonic seizures and myoclonic seizures are classified as what type of seizures?

Generalized seizures

Which type of seizures involves a loss of consciousness?

Generalized seizures

Which of the following interventions would be an appropriate part of a plan of care for a patient with a seizure disorder?

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

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

Inhibition of impulse conduction

A physician recently ordered a change in medication for a patient with a seizure disorder. Which of the following actions would the nurse take in evaluating the new drug's control of the seizure disorder?

Interview and observe for adverse effects

A patient has been diagnosed with a brain tumor, which has caused partial seizure activity. The patient is being treated with the newest antiepileptic medication. Which medication is administered as monotherapy to diminish or eliminate seizures?

Oxcarbazepine (Trileptal)

For which category of patients should the nurse take precautions while administrating barbiturates?

Patients with pulmonary disease

A nurse is caring for a patient with trigeminal neuralgia at a health care facility. The physician has prescribed carbamazepine. In which of the following cases is the use of carbamazepine contraindicated?

Patients with renal impairment

After teaching a patient who is receiving lamotrigine about possible adverse effects, the nurse determines that the patient has understood the teaching when the patient states that he will notify his health care provider immediately if he develops which of the following?

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 nurse is caring for a patient administered ethotoin. Which of the following are signs of toxicity that the nurse should monitor the patient for?

Slurred speech

A patient has been taking phenytoin (Dilantin) for a seizure disorder. He has recently run out of his medication and has not obtained a refill. What is the patient at risk for developing?

Status epilepticus

The nurse is planning patient education for a patient on antiseizure medications. The nurse should inform the patient that abrupt withdrawal from the medications can precipitate which of the following problems?

Status epilepticus

The seizure type that is characterized by generalized tonic-clonic convulsions lasting for several minutes during which the client does not regain consciousness is known as:

Status epilepticus.

A patient with partial seizures has been prescribed succinimides at a health care facility. The patient experiences GI upset after succinimides administration. What should the nurse instruct the patient to do?

Take the drug with food or milk.

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

The patient is at risk for increased CNS depression.

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

Use another form of birth control, such as condoms.

A common cause of seizures for a client in late infancy to early childhood is:

fever

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

oral

The nurse is caring for a 26-year-old woman with partial seizures. She has been prescribed oxcarbazepine (Trileptal) as monotherapy. It will be critical for the nurse to inform the patient

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