Chapter 58.2

A nurse reviews the medical history with a patient and learns that the patient was diagnosed with restless legs syndrome. Based on this fact, which question should the nurse also ask?

"Are you able to sleep well and feel rested?"

The nurse is teaching safety measures to a patient with seizure disorder who has a history of diabetes mellitus. Which statement made by the patient shows ineffective learning?

"I will refrain from doing physical exercises."

The nurse is educating a student nurse about how metabolic disturbances cause seizures. Which statements made by the student nurse indicate effective learning? Select all that apply.

"Seizures can be caused by a decrease in oxygen levels." "Seizures can be caused by a decrease in pH of the blood." "Seizures can be caused by a decrease in blood glucose levels."

A patient developed seizures after a head injury and informs the nurse he or she feels like there has been a loss of control over life since the seizures. Initially, what is the most appropriate response by the nurse?

"Tell me about what you would like to do and how the seizures affect you."

The patient has a prescription for phenytoin 100 mg q8hr intravenous (IV). Available is a phenytoin injection containing 50 mg/mL. How many milliliters of solution should the nurse draw up for the dose? Fill in the blank using a whole number. ___ mL

2 mL

Which diet is used to control seizures in some patients?

A diet with high fats and low carbohydrates

Which type of seizure is characterized by "drop attacks"?

Atonic seizure

The nurse should instruct the patient on phenytoin to perform which action to prevent gingival hyperplasia?

Brush the teeth at least twice per day.

A patient is brought to the emergency department by family members The family states that the patient suddenly fell down and became unconscious and the patient's left leg had jerky movements for a few seconds. Which type of seizure should the nurse suspect?

Clonic seizure

The nurse visits a patient who is being treated with phenytoin for seizures. Which instruction is important to prevent precipitation of seizures in this patient?

Do not stop the drug abruptly without consulting the health care provider.

A patient is prescribed carbamazepine for a new-onset seizure disorder. The nurse is educating the patient about this drug. What teaching comment by the nurse is most accurate?

Do not take this medication with grapefruit.

The caregivers of a patient with acute seizures ask the nurse what they should do if another episode of seizure occurs at home after discharge. What should the nurse tell them? Select all that apply.

Ease the patient to the floor. Loosen constrictive clothes Protect the patient from any injury.

A patient with a history of epilepsy is in the postanesthesia recovery unit (PACU) after surgery under local anesthesia. The patient has a tonic-clonic seizure that lasts two minutes. Which action should the nurse take while the patient is having the seizure?

Ensure the patient has a patent airway.

A patient with a seizure disorder failed to respond to drug therapy. Resection of epileptogenic tissue is performed. What could be the possible diagnosis?

Focal seizures

A patient displays jerky muscle movements of the extremities and is incontinent of bowel and bladder. With what does the nurse recognize these clinical manifestations to be associated?

Generalized seizures

A patient diagnosed with seizures is advised to take phenytoin. About which common side effects of phenytoin should the nurse inform the patient? Select all that apply.

Hirsutism Gingival hyperplasia

Which extracranial disorder can cause seizures?

Hypertension

The patient with type 1 diabetes mellitus with hypoglycemia is having a seizure. Which medication should the nurse anticipate administering to stop the seizure?

Intravenous (IV) dextrose solution

What should be the immediate nursing intervention provided to a patient with hypoglycemia who is suspected to have had a seizure?

Intravenous administration of dextrose

A nurse is educating a group of people in a community center about restless legs syndrome (RLS). Which risk factor included in the presentation would be inappropriate?

Liver failure

A patient with restless legs syndrome (RLS) failed to respond to gabapentin, which was prescribed earlier. What would be the drug of choice?

Oxycodone

A patient with a history of epilepsy experienced gingival enlargement. Which drug may be causing it?

Phenytoin

Which is the primary drug of choice for tonic-clonic seizures?

Phenytoin

A patient with systemic lupus erythematosus presents to the emergency room with warm skin and pallor. The nurse observes that the patient is lethargic and has an altered level of consciousness. What seizure phase is this patient most likely experiencing?

Postictal phase

What is the nursing action of highest priority to be taken with a patient who experiences a generalized tonic-clonic seizure?

Protecting the head and extremities

What instructions should a nurse give to a patient who has focal seizures well controlled with phenytoin and who has mild gingival hyperplasia? Select all that apply.

Regular tooth brushing can limit hyperplasia. Regular flossing can control gingival tissue growth.

A patient with a suspected seizure failed to respond to drug therapy and reports unusual sensations and hallucinations. What could be the effective surgical treatment?

Resection of epileptogenic tissue

A patient with hypertension reports paresthesia, tingling, and a pins and needles sensation. The patient was prescribed gabapentin. What is the possible diagnosis?

Restless legs syndrome (RLS)

The nurse is teaching home care measures to the caregiver of a patient with seizures. Which action made by the patient's caregiver during an acute seizure episode indicates the need for additional teaching?

Sending the patient to hospital immediately after a single seizure

Which characteristic feature is exclusively seen in a complex focal seizure?

Smacking of the lips

Which type of seizure lasts longer than five minutes and occurs in rapid succession without return to consciousness between seizures?

Status epilepticus

A patient with head trauma is being sedated and is on a ventilator in the intensive care unit. What type of seizure might this patient experience?

Subclinical seizure

Arrange the phases of a seizure chronologically.

The phase with signs that precede a seizure The phase with a sensory warning of a seizure The phase with a full seizure The phase with recovery period after a seizure

Which characteristic of a patient's recent seizure is consistent with a focal seizure?

The seizure involved lip smacking and repetitive movements.

The nurse admits a young adult patient with epilepsy to the trauma unit following a motor vehicle accident. The patient asks the nurse about the incidence of the condition. What response by the nurse is most appropriate?

Thirty percent of all epilepsy cases are not attributable to a specific cause

What seizure disorder typically occurs in children and rarely continues beyond adolescence?

Typical absence seizures

The nurse assesses a patient for signs of petit mal, or absence, seizures. What is the classic sign of this seizure disorder?

Vacant facial expression

Arrange the steps of vagal nerve stimulation chronologically.

Vagal nerve stimulation is used when surgery is not feasible to treat seizures. In this process, an electrode is implanted in the neck. A magnet can activate this electrode, which delivers the electrical impulse and prevents the seizure from occurring.

The patient with epilepsy is due for a dose of carbamazepine. The serum carbamazepine level today is 18 mcg/mL. What is the priority nursing action?

Withhold the dose and telephone the health care provider with the result.

What has been shown to improve mood, sleep, and function in patients with restless leg syndrome?

Yoga