Chapter 18: Drugs Used for Seizure Disorders

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

30 mg/min

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.

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

Administer without mixing with other medications.

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? (Select all that apply.)

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. ANS: A, D, E

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

Consult an obstetrician. Carry an identification card. Provide a list of seizure medications. ANS: A, C, D

Which condition is associated with hydantoin therapy?

Gingival hyperplasia

The nurse is preparing discharge instructions for a patient with a history of diabetes who has just been diagnosed with seizure disorder. The patient has been prescribed hydantoin therapy. What will the patient most likely experience?

Hyperglycemia

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

Nystagmus

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 ANS: B, D, E

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 ANS: A, D, E

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

Topiramate (Topamax)

For which condition may carbamazepine (Tegretol) be used?

Trigeminal neuralgia pain

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

Valproic acid (Depakene)

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

Determine patient's ancestry.

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 ANS: A, B, D, F

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."