Quiz 3

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"Acupuncture may be very relaxing."

"Antiseizure medications will probably be continued for life."

"Call the office immediately if you feel like hurting or killing yourself."

"Donepezil (Aricept) may help slow cognitive decline."

"Garlic may help with this disease."

"Ginkgo biloba may help with memory."

"It will not improve dementia but can help control emotional responses."

"It will provide a steady improvement in memory."

"Music therapy has been found to help some clients."

"My blood glucose is under control."

"My blood pressure is coming down."

"My doctor prescribed it for the pain in my legs." Correct answer

"Phenytoin prevents any further occurrence of seizures."

"The medication might cause me to have insomnia."

"This medication needs to be taken during periods of emotional stress."

"You might experience irregular menses and intermittent bleeding."

"You should avoid becoming pregnant while taking this medication."

"You should stay away from large crowds and sick children."

"Your antiseizure medication usually can be stopped after a year's absence of seizures."

'Avoid driving or hazardous activities until any side effects such as drowsiness can be determined.'

'She's eating high-calorie foods, and we encourage fluids, too.'

'Some anticonvulsants interfere with vitamin and mineral absorption, so you may need a supplement.'

'Stop taking the medication if you become pregnant.'

'Stop the medication immediately if a rash develops.'

'Stopping the medications can cause continuous seizures and I may die.'

'Take the child for regularly scheduled blood tests.'

'Take the medication on an empty stomach.'

'Take this medication between meals.'

'Taper off the medication if seizures are controlled for 3 months.'

'The medication has the potential for physiological and psychological dependence.'

'There's a medication that will prevent this problem.'

'These medicines must be continued to prevent falls and injury.'

'This is a temporary response to the medication; it usually stops after a few weeks.'

'This medication rarely causes dependence when the dosage is controlled.'

'We give the medication between meals.'

'We'll call the clinic if her urine turns pink.'

'We'll have her massage her gums and floss her teeth frequently.'

A high-protein diet should be followed.

A rash is normal with this medication

Abdominal pain

Absorption of iron from foods is improved.

Acetazolamide

Additive

Administer naloxone.

Administer the medication at bedtime.

Administer the medication between meals.

Administer the next dose of the medication as prescribed.

Administration of paroxetine may be needed to prevent adverse effects.

Agranulocytosis

Alcohol

Alcohol consumption should be in moderation.

Allergic

Allopurinol

Alprazolam

Amnesia

Amphetamines

Antidepressant

Antidepressants

Antipsychotic

Apply ice packs.

Assess the abdomen for distention.

Assess the apical pulse.

Assess the pupillary response

Assessing the mouth for gingivitis

Ataxia

Atropine

Avoid eating meals that are high in protein

Avoid grapefruit juice when taking this medication

Barbiturates

Benzodiazepine

Benzodiazepines are the first-line medications used in chronic anxiety disorders.

Blocks the effects of acetylcholine

Blood tests that reflect liver function will be performed routinely.

Blood work will be required if you have a seizure while taking this medication

Blurred vision

Bradycardia

Brain activity is suppressed, and the risk of depression increases.

Breast enlargement

Bring the partner to the clinic for testing and a physical examination.

Buspirone

Caffeine

Call the health care provider to obtain a prescription with an increased dose.

Carbamazepine

Carbidopa-levodopa

Cardiac dysrhythmias

Check reflexes every 2 hours.

Check the blood pressure.

Check the client's blood pressure.

Check the skin turgor

Chlorpromazine

Clarify the prescription with the health care provider.

Clonazepam

Coconut oil

Cognitive impairment

Constipation

Constipation should be reported to the primary health care provider immediately.

Continuous infusion of dextrose 5% in 0.9% saline

Control of hypertonicity and prevention of seizures

Control of laryngospasms and neck and jaw rigidity

Decreased anxiety

Decreased blood pressure.

Decreased heart rate

Decreases anxiety associated with seizures

Depresses the central nervous system (CNS)

Diarrhea

Diazepam

Dilation of airways

Disulfiram

Dizziness

Donepezil

Dopamine

Drowsiness

During the procedure, the medication should be given as needed for pain management.

Dystonic

Eat plenty of whole-grain foods when taking this medication

Echinacea

Emotional changes

Enables the client to sleep better during periods of agitation

Encourage the ventilation of feelings.

Encourages the client to accept treatment for alcoholism

Epinephrine HCl

Examine the client's pupils daily.

Extrapyramidal

Higher doses are needed to accommodate physiological changes during pregnancy.

Hold the medication and collaborate with the provider prior to administration

Hold the medication and notify the health care provider.

Hold the next dose and then resume administration as prescribed.

Hyperactivity is seen with long-term use.

Hypertension

Hypertensive urgency

Hypoglycemia

I will hold the dose if my seizures are controlled

I will notify my healthcare provider if I have significant mood changes

I will record the number of seizures I experience

I will report any weight gain to my healthcare provider

Idiosyncratic

If you miss a dose, double the next scheduled dose

Imipramine

Improvement in myelination of neurons

Increase coordination and the ability to concentrate

Increase in acetylcholine production

Increased appetite

Increased attention span.

Increased salivation.

Increases the production of dopamine

Insert a urinary retention catheter.

Insomnia

Isocarboxazid

It induces sedation.

It is important to monitor for spikes in blood pressure elevation during administration.

It is normal to have a change in your gait when you first start this medication

It limits oral secretions.

It prevents respiratory depression.

Lessening of tremors.

Lethargy

Lethargy results, and it prevents a return to interpersonal activity.

Leucovorin

Lifelong treatment is often required.

Lithium

Lorazepam

Maintain airway.

Mania

Methadone

Methylphenidate

Midazolam

Minimizes withdrawal symptoms the client may experience

Modafinil

Monitor for signs of increased anxiety.

Monitor vital signs every 15 minutes.

Monitoring the child's complete blood cell counts

Motor restlessness

Multivitamins should be taken daily.

Naloxone

Nausea

Neuropathy caused by phenytoin is prevented.

Notify your healthcare provider if your urine appears dark

Paradoxical

Paradoxical excitation

Paroxetine

Percuss the abdomen

Phenelzine

Phenobarbital

Phenytoin

Phenytoin competes with warfarin for receptor occupation.

Phenytoin inhibits absorption of folate from foods.

Pinch the line above the infusion port during the administration

Polycythemia

Prepare a setup for a central venous pressure (CVP) line.

Prevention of excess oxygen and caloric expenditure

Prevention of restlessness and resistance to assisted ventilation

Prevents injury when seizures occur

Reduce anxiety and provide a calming effect

Reduce symptoms of depression

Reduced blood pressure

Reduction in dysrhythmias

Refrain from renewing prescription.

Regeneration of injured thalamic cells

Relaxing of peripheral muscles

Replacement of a neurotransmitter in the brain

Report of anorexia, numbness and tingling of the extremities

Report of any seizure activity

Respiratory depression

Restores the dopamine levels in the brain

Ringing in the ears

Seizure activity

Seizures

Sensitivity to bright light or sun

Sertraline

Serum phenytoin levels

Serve a diet that is high in iron

Short-term relief can be expected

Sleep driving

Somnolence

Stop the infusion and flush the port with normal saline prior to administration

Supplement the diet with high-calorie foods.

Suvorexant

Switch to using an antidepressant.

Synergistic

Taper dose over several months.

Tardive dyskinesia

Tardive dyskinesia is common early in treatment.

Temazepam

The amount prescribed is insufficient to cover activities.

The client asks for an extra bottle of flavored water to drink with dinner.

The client denies having auditory hallucinations.

The client denies having suicide ideation.

The client is prescribed a medication that is ineffective in preventing seizures.

The client removes the pepperoni from a pizza.

The client reports feeling less depressed.

The client reports sleeping through the night.

The client's medication dosage may be self-adjusted according to the client's response.

The depression is magnified, and the risk of suicide increases.

The increments should be smaller, and the rate of injection should be slower.

The medication acts as a stimulant

The medication should be taken with meals.

The nurse determines a need to reduce her anxiety.

The period of denial is extended, and the grieving process is suppressed.

The prescribed antiseizure medication probably is not taken consistently.

The primary health care provider is getting ready to perform a vaginal examination.

The provider failed to account for a growth spurt.

The use of grapefruit juice should be avoided.

These medications depress activity in the brainstem.

These medications have both analgesic and antidepressant properties.

These medications increase the activity of gamma-aminobutyric acid.

This medication will stop the progression of your condition

To calm the client and promote acceptance of the treatment plan

To enable the client to sleep better during periods of agitation

To prevent injury when seizures occur

To reduce the anxiety tremor state and prevent more serious withdrawal symptoms

Twitching

Unusual bleeding or bruising

Urinary retention

Urticaria

Valproic acid

Venlafaxine

Warfarin decreases phenytoin absorption.

Warfarin inhibits the metabolism of phenytoin.

Warfarin promotes excretion of phenytoin.

Watch for a reddish-brown discoloration of urine.

Withdrawal

Yellow sclerae

You will need to have routine visits with a dentist when taking this medication

Zolpidem

First-generation antipsychotics

Fluids should be limited to 4 large glasses per day.

Flumazenil

Folic acid potentiates the action of phenytoin.

Frequent urination

Gait

"I can stop taking the medication at any time."

"I have been sleeping better."

"I have less pain."

Gingival hyperplasia

Ginkgo biloba

It reduces pain.

Omega-3 fatty acids

Provide good oral hygiene.

They are indicated for ethanol withdrawal.

"It is safe to take extra doses if my pain becomes worse."

"It is used to halt the progression of Alzheimer's disease."

'You may experience dizziness when moving from sitting to standing.'

'You may require increases in your dosage; however, it rarely causes dependence.'

2) Which statement by the nurse reflects teaching for a client recently initiated on anticonvulsants? Select all that apply. One, some, or all responses may be correct. A. 'It is important to take the medication at the same time every day with meals.' B. 'It is important to not drink excessive amounts of caffeine-containing beverages or alcohol.' C. 'Avoid driving or hazardous activities until any side effects such as drowsiness can be determined.' D. 'Some anticonvulsants interfere with vitamin and mineral absorption, so you may need a supplement.' E.'Oral hygiene, such as gum massage and tooth brushing, is important to combat the gingival hyperplasia that some anticonvulsant medication can cause.'

A,B,C,D,E Rationale When initiating anticonvulsant medication, it is important to maintain consistent levels of the medication, so the patient would take it at the same time every day and with meals for absorption. It is important not to drive or perform any hazardous activities as new medications can cause drowsiness. There is some evidence that caffeinated and alcoholic beverages lower seizure threshold. Adding a multivitamin supplement is recommended, especially if the anticonvulsant is the kind that interferes with absorption. Frequent dental examinations and good oral hygiene are the first line of defense against the gingival hyperplasia caused by some anticonvulsants.

Alleviate signs and symptoms of spasticity

Ask the pharmacy to mix the medication into an IV piggyback (IVPB) infusion

Atomoxetine

3) Status epilepticus develops in an adolescent with a seizure disorder who is taking antiseizure medication. Which reason would the nurse identify as the most common reason for the development of status epilepticus? A. The provider failed to account for a growth spurt. B. The amount prescribed is insufficient to cover activities. C. The prescribed antiseizure medication probably is not taken consistently. D. The client is prescribed a medication that is ineffective in preventing seizures.

C, D Rationale Skipping doses of the medication is a form of denial that an adolescent client may engage in once the seizures are controlled; also, adolescents tend to feel invincible. The dosage is based not on activity but on the type of seizure. Medications are prescribed according to the type of seizure and are effective if taken consistently. The dosage of antiepileptic medications is based on many factors, including age, type of medication, and presence of infection, as well as on changes in height and weight.

Checking the pupillary reaction to light

Examine the oral cavity

Give activated charcoal.

Give intravenous fluids.

Give the medication with food.

Hallucinations

Headache

Heroin

Hypotension

Keeping an accurate intake and output record

Ketorolac 15 mg IV push as needed for pain

Kidney failure

Labetalol 100 mg orally twice per day Your Answer

Maintain good oral hygiene and dental care

Measure the client's urine output.

NPH insulin 40 units before meals

1) A client is admitted to the emergency department after experiencing a seizure. Which action would the nurse take first? Ask the emergency provider for a prophylactic anticonvulsant. Obtain a history of seizure type and incidence. Ask the client to remove any dentures and eyeglasses. Observe the client for increased restlessness and agitation.

Obtain a history of seizure type and incidence. Data collection is an essential first step for a client with a seizure disorder; it should always include a history of the seizures (e.g., type and incidence). Because different seizure medicines are used to control different seizure types, it is important to determine the type before treating. Although dentures and eyeglasses may be removed during a seizure, the client's normal routines should be respected. Increased restlessness may be evidence of the prodromal phase of a seizure in some individuals, but signs and symptoms vary so widely that the client's history should be obtained.

Omit 1 dose today and start with a lower dose tomorrow.

Omit the medication if the child is seizure-free

Opiate

Opioids

Pain intensity

Pain relief

Promotes rest after the seizure episode

Promotes the production of acetylcholine

Provides amnesia for the convulsive episode

Pyridoxine (vitamin B 6)

Range of motion

Rebound insomnia may occur if the medication is discontinued abruptly.

Report of unsteady gait, rash and diplopia

Tachycardia

Tachypnea

The client requests a prescription for oral contraceptives before being discharged.

The client requests something to calm her.

The client states that chewable antacids may be taken to relieve heartburn.

The client's crying increases.

The medication should be given as a rapid intravenous push.

The medication works by suppressing dopamine

"It will help your mother live independently again."

'Provide oral hygiene, especially gum massage and flossing.'

'This means that your baby's dosage needs to be adjusted.'

'Crush the tablets and mix them with applesauce.'

'I will not have any seizures with these medications.'

'It can cause happy feelings followed by feelings of depression.'

'It is important to not drink excessive amounts of caffeine-containing beverages or alcohol.'

'It is important to take the medication at the same time every day with meals.'

'It usually results in psychological but not physiological dependence.'

'Many infants experience the same problem, but your baby needs the medication.'

'Oral hygiene, such as gum massage and tooth brushing, is important to combat the gingival hyperplasia that some anticonvulsant medication can cause.'

'Provide meticulous oral hygiene.'

'Blood levels of the medication should be monitored weekly.'

'By my staying on the medicines I will prevent postseizure confusion.'

4) A client has a tonic-clonic seizure caused by an overdose of aspirin. Which action would the nurse take next? A. Check reflexes every 2 hours. B. Insert a urinary retention catheter. C. Monitor vital signs every 15 minutes. D. Prepare a setup for a central venous pressure (CVP) line. Rationale Because of the lethal toxicity of an aspirin overdose, hypotensive crisis and cardiac irregularities can occur. The central nervous system is not involved at the reflex level at this time. Inserting a urinary retention catheter is not the priority at this time. CVP readings are not indicated in this situation.

C Rationale Because of the lethal toxicity of an aspirin overdose, hypotensive crisis and cardiac irregularities can occur. The central nervous system is not involved at the reflex level at this time. Inserting a urinary retention catheter is not the priority at this time. CVP readings are not indicated in this situation.

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