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What can occur as a result of rapid withdrawal from long term use of barbiturate therapy?

Anxiety Delirium Weakness Grand mal seizures

The nurse is caring for an older patient recently admitted to an assisted living center who is experiencing insomnia associated with the recent relocation. At bedtime, which nursing

Perform back massage

The nurse is administering Somnote to a patient. When providing medication education to the patient, the nurse will include that Somnote should be:

taken with a full glass of water.

What dose is within the acceptable range for administering IV phenytoin (Dilantin) to a patient with a seizure disorder

30 mg/min

Which sleep pattern stage diminishes as an effect of aging?

Stage IV

A patient on anticonvulsant therapy confides to the nurse at an outpatient clinic that she sus pects she may be pregnant. The nurse should encourage the patient to take which action(s)? (Select all that apply.

Carry a identification cord Consider or contraception Consult a obstetrician

What information would be most important for the nurse to provide to a patient when teaching about the adverse effects of succinimide therapy

Nausea, vomiting, and indigestion are common during the initiation of therapy.

Which medication is used to control seizures or prevent migraine headaches?

Topiramate (Topamax)

For which condition may carbamazepine (Tegretol) be used?

Trigeminal neuralgia pain

Why are benzodiazepines often preferred over barbiturates

They have selective action at specific receptor sites. There is a wide range of safety between therapeutic and lethal levels. REM sleep is decreased to a lesser extent. Accidental overdoses are well tolerated.

The nurse is providing education to a patient recently prescribed pregabalin (Lyrica). Which statement by the patient indicates a need for further instruction?

"Once my pain improves, I will stop taking this medication."

A patient has been prescribed lorazepam (Ativan), a benzodiazepine used to treat insomnia. Which action will the nurse take?

Assess the patient's blood pressure in sitting and lying positions.

For what conditions are benzodiazepines prescribed?

Preoperative sedation

The health care provider orders diazepam (Valium) 10 mg IV stat for a patient who was admitted with status epilepticus. What important nursing interventions(s) associated with administration of this medication IV should the nurse perform?

Apply a cardiac monitor to the patient to assess for continuous heart rate, if not already done. Continuously assess the patient's airway. Obtain the correct dose (10 mg) and administer over slow IV push.

In addition to facilitating sleep, what is another benefit of sedatives?

Decreased patient anxiety

The pediatric nurse is caring for a patient diagnosed with refractory seizures. The physician orders a ketogenic diet. When the child receives his food tray, the nurse should remove any food containing high levels of

carbohydrates

Which condition is associated with hydantoin therapy?

gingival hyperplasia

A patient receiving diazepam (Valium) is complaining of nausea and vomiting and is becoming jaundiced. Which type of blood work will be performed?

liver function tests

Which disease is associated with insufficient sleep?

myocardial infarction

Which condition would indicate to the nurse that a patient has phenytoin (Dilantin) toxicity?

nystagmus

What is the drug of choice when treating a generalized tonic clonic seizure?

Valproic acid (Depakene)

The nurse is assessing a patient who is being evaluated in an outpatient clinic for complaints of back pain. The patient reports taking diphenhydramine for insomnia related to job stress. Which statement by the nurse is accurate regarding this medication?

"This medication should only be taken for 1 week."

What is a guideline for the nurse when administering phenytoin (Dilantin) intravenously?.

Administer without mixing with other medications.

Patients taking phenytoin (Dilantin) for control of seizures must be aware of the risk for which adverse effect(s)? ( Select all that apply. )

Blood dyscrasias Hyperglycemia Gingival hyperplasia sedation

Which premedication assessment by the nurse is most important prior to the initiation of carbamazepine (Tegretol) therapy?

Determine patient's ancestry.

The nurse is explaining the use of medications to a patient with insomnia. Which statement about sedatives is true?

Increased relaxation occurs with sedatives.

The nurse is preparing to administer zonisamide (Zonegran) to a newly admitted patient with the diagnosis of adult partial seizures. The nurse should hold this medication if the patient has which sign(s) or symptom(s)? (Select all that apply.)

Skin rash Allergy to Bactrim Pruritus

The nurse finds that a patient is extremely agitated, yells frequently, and is attempting to get out of bed without assistance. What is the nurse's initial action?

Spend uninterrupted time listening to the patient.

Which response by the nurse is accurate when a patient who has been on lamotrigine ( Lamictal) for seizure control reports a skin rash and urticaria?

Advise the patient that this adverse effect usually resolves but should be reported to the health care provider.

Barbiturates have which common adverse effect(s)?

Residual daytime sedation Headache Blurred vision Impaired coordination

An older adult patient received a hypnotic agent at 9:00 PM. At 2:00 AM, the nurse discovers that the patient has removed her gown and is attempting to get out of bed without assistance. What type of medication effect is the patient exhibiting?

paradoxical

When reviewing a patient's history and physical information, the nurse notes that the patient has physician's orders for chloral hydrate and warfarin. During assessment of this patient, the nurse observes areas of petechiae and ecchymosis on the upper and lower extremities. The most appropriate lab work for the nurse to assess next is:

prothrombin time.

The nurse is providing discharge teaching to a patient prescribed phenytoin (Dilantin) for management of a seizure disorder. Which patient statement indicates a need for further teaching?

"If I develop enlarged gums, I will stop taking the medication."

What is included in the nursing management of the patient with generalized tonic clonic seizure activity? ( Select all that apply. )

Placing padding around or under the patient's head Positioning the patient on the side once the relaxation stage is entered to allow oral secretions to drain Requesting additional assistance and/or necessary equipment in case the patient does not begin breathing spontaneously when the seizure is over