NURS 125: Chapter 23: Anti-seizure Agents

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

An 8-year-old child who weighs 66 lbs. has been diagnosed with a partial seizure disorder and has been prescribed carbamazepine 25 mg/kg PO per day in three divided doses. How many 100-mg chewable tablets should the nurse teach the child's parents to administer for each dose?

2.5

A client is receiving phenytoin. The nurse monitors the client's plasma drug level. Which level would alert the nurse to the possibility of toxicity?

27 µg/mL

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

CNS depression

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

Carbamazepine

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

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

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

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?

Ethosuximide

The nurse instructs the parent of a young school-age child with a seizure disorder who takes an AED to be alert for what signs and symptoms?

Excessive sedation and interference with learning and social development

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

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

Oral

The nurse is reviewing the medical record of a client with partial seizures who is prescribed drug therapy. The nurse would question the order for what if the nurse finds that the client has a history of alcohol abuse?

Pregabalin

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

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

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

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

aura

A client taking phenytoin for a seizure disorder wants to take a new herbal preparation to help with adverse effects of the medication. Which herb(s) should the nurse instruct the client to avoid taking? Select all that apply.

evening primrose ginkgo biloba

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