Pharmacology Chapter 22: Anticonvulsants
A nurse is providing teaching for a client taking phenytoin (Dilantin). Which client statement indicates a good understanding of the teaching?
"Alcohol is contraindicated with Dilantin."
A client with a known seizure disorder is being treated with phenytoin (Dilantin). The client becomes pregnant. Which recommendation would be appropriate for the nurse to make?
"Contact your healthcare provider right away; you should not take Dilantin while pregnant."
The client has been started on phenytoin and reports to the nurse that he also takes ginkgo. What is the most accurate response from the nurse?
"Ginkgo can decrease the effectiveness of phenytoin."
A nurse is teaching a client about her health plan when taking phenytoin (Dilantin). Which instruction would not be included in the teaching plan?
"avoid use of oral contraceptives."
A client with a known seizure disorder is treated with several anticonvulsant medications. The client confides in the nurse, stating that he also has a strong belief in complementary medicine and takes several herbal supplements. Which is an appropriate response by the nurse?
"check with your healthcare provider to ensure there are no harmful drug interactions."
A client taking anticonvulsants for epilepsy should receive which instruction from the nurse?
"the medication is usually taken for a lifetime."
A client is ordered to receive phenytoin (Dilantin). The client's serum phenytoin level is noted to be 15 mcg/mL. How does the nurse interpret this level?
10 to 20 mcg/mL is therapeutic
The client with ________ would not be a candidate for treatment with valproic acid (Depakene).
a liver disorder
Gastric irritation may occur when taking ethosuximide (Zarontin). The nurse suggests taking the drug:
at mealtime or immediately after a meal
A child is brought to the healthcare provider's office. The child has been receiving phenytoin (Dilantin) for seizure activity. The family reports that despite the child's previously reported controlled seizures, the child has been seizing two or three times a day. The nurse would anticipate that the:
child's phenytoin level will be drawn
A child enters the emergency department. The paramedics report that the child has been having a seizure that has lasted for 45 minutes. In addition to securing and maintaining an airway, what is a priority intervention on the part of the nurse?
diazepam (Valium)
A client enters the emergency department in status epilepticus. The nurse anticipates the administration of:
diazepam (Valium)
Which of the following dietary restrictions is indicated with carbamazepine (Tegretol)?
do not drink grapefruit juice
A client with a known seizure disorder enters the emergency department. The nurse notes that his gums are swollen and bleeding. What is a priority nursing intervention?
draw a phenytoin level
A client is ordered to receive an anticonvulsant for seizure activity. Which side effects are most prevalent with clients who take drugs in this class?
drowsiness and lethargy
A client has been receiving phenytoin (Dilantin) for 15 years. The nurse implements which diagnostic test to assess for a common adverse reaction to long-term medication use?
fasting blood glucose level
A client taking phenytoin (Dilantin) is admitted to the emergency department with a level of 30 mcg/mL. The nurse would evaluate for the severe side effect of:
gingival hyperplasia
A client has been taking phenytoin (Dilantin) for 10 years. This client should be evaluated for:
hyperglycemia
The client has been started on phenytoin. He reports experiencing reddish-colored urine. What is the nurse's highest priority intervention?
instruct the client that this is an expected side effect of the medication
A client with a new seizure disorder is ordered to receive phenobarbital (Luminal) for seizures. The nurse would expect:
lethargy
The client has been started on valproic acid. Her level of the medication is drawn and is found to be 60 mcg/mL. The nurse notes that this is a(n) _____ level.
therapeutic
