Ch 15: Seizures
C. Disorientation D. Agitation E. Lethargy Signs of overmedication include agitation, disorientation, and changes in level of consciousness such as lethargy. These signs should be reported immediately to the healthcare provider. Vomiting and tachypnea are not signs of overmedication.
The nurse is concerned that a client taking an antiepileptic drug (AED) may be overmedicated. Which sign should the nurse recognize as the result of overmedication? (Select all that apply.) A. Vomiting B. Tachypnea C. Disorientation D. Agitation E. Lethargy
D. It can be safely taken with steroids
The nurse is teaching a client taking phenytoin (Dilantin) about drug interactions. Which information should the nurse include? A. It may alter the effectiveness of calcium. B. Ginkgo increases the antiseizure effect of phenytoin. C. It has no effect on oral contraceptives. D. It can be safely taken with steroids.
C. "I will not give my child the medication with milk." Barbiturates affect the absorption of folic acid and vitamins K, D, and B. Clients should be encouraged to eat a diet rich in these vitamins, including milk. Children on phenobarbital may have hyperactivity and should be monitored closely. Many clients on antiepileptic drugs (AEDs) may develop bleeding or bruising. School performance, along with height and weight, should be monitored in children.
The nurse records the progress of a school-age child who takes phenobarbital for seizure activity. Which statement by the mother should indicate the need for further teaching? A. "I will monitor my child for rashes or bruising." B. "I will report any decrease in grades to my healthcare provider." C. "I will not give my child the medication with milk." D. "I will monitor my child for hyperactivity."
A. Tonic-clonic The tonic phase begins with loss of consciousness and intense muscle contraction. The clonic phase is defined by muscles alternating between contracting and relaxing (convulsions). Tonic-clonic seizures typically last for 1 to 2 minutes. Clients with atonic seizures lose control of all muscles for a few seconds. The client will stumble or fall. Absence seizures are characterized by staring and a brief loss of consciousness. Myoclonic seizures present as jerking movements of the neck, shoulders, and upper arms and only last a few seconds.
A client experienced disorientation after having a seizure that lasted 2 minutes with a period of intense muscle contraction followed by convulsions. For which type of seizure should the nurse plan care for this client? A. Tonic-clonic B. Myoclonic C. Absence D. Atonic
A. Minor electrolyte imbalances B. Strobe or flickering lights C. Sleep deprivation E. Slight fluid imbalances
A client has a history of seizure activity. For which trigger should the nurse assess this client? (Select all that apply.) A. Minor electrolyte imbalances B. Strobe or flickering lights C. Sleep deprivation D. Anxiety E. Slight fluid imbalances
A. "Barbiturates have a high potential for drug dependence, so you will be monitored closely by your healthcare provider." Barbiturates have a high potential for drug dependence. Clients should be monitored closely and instructed about this risk. Tachycardia, hypertension, and diarrhea are not associated with barbiturates.
A client has been prescribed a barbiturate for epilepsy. Which information should the nurse include in medication teaching? A. "Barbiturates have a high potential for drug dependence, so you will be monitored closely by your healthcare provider." B. "Check your blood pressure daily because barbiturates can cause hypertension." C. "Barbiturates can cause diarrhea, so your healthcare provider will prescribe a medication to treat that." D. "Report any palpitations because barbiturates can cause tachycardia."
A. Hypotension B. Tachycardia E. Respiratory depression
A client is given intravenous diazepam for status epilepticus. For which adverse effect should the nurse monitor this client? (Select all that apply.) A. Hypotension B. Tachycardia C. Hyperactivity D. Flatulence E. Respiratory depression
C. Diazepam Status epilepticus (SE) is a medical emergency characterized by a continuous seizure lasting more than 30 minutes, or two or more seizures without full recovery of consciousness. Intravenous (IV) administration of diazepam is the preferred treatment for this health problem. SE is not treated with topiramate, gabapentin, or valproic acid.
A client is in status epilepticus. Which medication should the nurse anticipate being prescribed for this client? A. Topiramate B. Gabapentin C. Diazepam D. Valproic acid
B. Ethosuximide (Zarontin) The first-line treatment for absence seizures is ethosuximide. Gabapentin is used for partial seizures. Methsuximide is not identified as being used to treat absence seizures. Phenytoin is not used to treat absence seizures.
A client is newly diagnosed with absence seizures. Which medication should the nurse anticipate will be prescribed as a first-line treatment? A. Gabapentin (Neurontin) B. Ethosuximide (Zarontin) C. Phenytoin (Dilantin, Phenytek) D. Methsuximide (Celontin)
B. Current medications and drug allergies C. History of seizures D. History of closed-angle glaucoma Prior to medication administration, the nurse should obtain a complete health history. History of seizures (frequency, duration, physical symptoms, preseizure symptoms, and length of postictal period) should be obtained. Closed-angle glaucoma may be a problem with a client taking benzodiazepines as they increase intraoptic pressure. To prevent drug interactions, a list of current medications, including any herbal or over-the-counter (OTC) medications, should be included. Family history of cardiac disease and knowledge of the number of live births that a client may have are not necessary for antiepileptic drug (AED) administration.
A client is newly diagnosed with mixed seizure disorder. Which information should the nurse assess prior to medication administration? (Select all that apply.) A. Number of live births B. Current medications and drug allergies C. History of seizures D. History of closed-angle glaucoma E. Family history of cardiac disease
A. Absence Succinimides are medications that suppress seizures by delaying calcium influx into neurons. By raising the seizure threshold, succinimides keep neurons from firing too quickly and suppress abnormal foci. They are generally only effective against absence seizures. Succinimides are not indicated to treat absence, tonic-clonic, or complex partial seizures.
A client is prescribed a succinimide for seizure activity. For which type of seizure should the nurse assess this client? A. Absence B. Tonic-clonic C. Complex partial D. Febrile
A. Metoprolol C. Cimetidine D. Levodopa E. Phenytoin
A client is prescribed diazepam (Valium) for a seizure disorder. For which additional medication should the nurse question providing this medication? (Select all that apply.) A. Metoprolol B. Warfarin C. Cimetidine D. Levodopa E. Phenytoin
C. Glaucoma D. Prostatic hypertrophy
A client is prescribed phenobarbital (Luminal) for a seizure disorder. For which reason should the nurse question providing this medication to the client? (Select all that apply.) A. Osteoarthritis B. Gastroenteritis C. Glaucoma D. Prostatic hypertrophy E. Heart disease
A. AEDs deplete folic acid. C. AEDs have teratogenic effects.
A client taking an antiepileptic drug (AED) is considering becoming pregnant. Which information should the nurse provide this client? (Select all that apply.) A. AEDs deplete folic acid. B. Single-drug therapy is recommended. C. AEDs have teratogenic effects. D. Multiple-drug therapy is recommended. E. AEDs cause placenta previa.
A. Sedative-hypnotic drugs C. Cocaine D. Alcohol
A client with a history of substance use is having seizures. Which substance should the nurse suspect is causing this activity? (Select all that apply.) A. Sedative-hypnotic drugs B. Amphetamines C. Cocaine D. Alcohol E. Ecstasy
A. "Convulsions are not seen in absence seizures." Convulsions are not a characteristic of absence seizures. Absence seizures involve staring, brief loss of consciousness, or eyelid fluttering. Medications may prevent convulsions, but this is not the reason the client is not experiencing them. Clients who have other types of seizures with convulsions may lose consciousness and not remember them.
A client with absence seizures asks why convulsions never occur. Which response should the nurse make? A. "Convulsions are not seen in absence seizures." B. "Many clients have convulsions but cannot remember they had them." C. "If you have never had convulsions, you cannot be having absence seizures." D. "You are on medication to prevent convulsions."
A. Monitor cardiovascular status during and after administering B. Use a filter when infusing the medication D. Flush the intravenous line with normal saline before and after administering E. Provide the medication at a rate of 50 mg/min
A client with status epilepticus is prescribed intravenous (IV) phenytoin (Dilantin). Which should the nurse consider when administering this medication? (Select all that apply.) A. Monitor cardiovascular status during and after administering B. Use a filter when infusing the medication C. Mix the medication in an intravenous solution containing dextrose D. Flush the intravenous line with normal saline before and after administering E. Provide the medication at a rate of 50 mg/min
A. Memory impairment D. Balance deficits E. Toxic serum levels Taking multiple medications puts the older client taking antiepileptic drugs (AEDs) at increased risk for toxic serum levels. Therefore, serum levels should be monitored closely. Balance deficits increase an older client's risk for falls. The older client should be instructed to rise slowly and call for help if needed. Memory impairment means the older client may forget to take medication. It is important for the older client to take the medication at the same time each day. Hypertension and urinary incontinence are not associated with older clients taking AEDs.
An older client taking multiple medications for other health problems is prescribed an antiepileptic drug (AED). Which potential issue should the nurse anticipate for this client? (Select all that apply.) A. Memory impairment B. Urinary incontinence C. Hypertension D. Balance deficits E. Toxic serum levels
B. Febrile seizure Febrile seizures are characterized by high temperatures and tonic-clonic movements. Loss of consciousness is brief and seizures typically last 1 to 2 minutes. An elevated temperature is not associated with absence seizures, status epilepticus, or Lennox-Gastaut syndrome.
A 2-year-old child has intense muscle contractions and a fever of 104.3° F. Which health problem should the nurse suspect in this client? A. Absence seizure B. Febrile seizure C. Status epilepticus D. Lennox-Gastaut syndrome
