Quiz: Chapter 18, Drugs Used for Seizure Disorders

A patient prescribed lamotrigine (Lamictal) for seizure control is also taking an analgesic for back pain. Which instruction would the nurse provide to prevent complications?

"Do not drive vehicles when you are taking the medication."

A patient who is taking an estrogen-containing contraceptive is prescribed oxcarbazepine (Trileptal) for seizure control. Which instruction would the nurse provide to prevent complications?

"Use another form of birth control."

Which range represents a therapeutic blood level for levetiracetam?

10 to 40 mg/L

A patient who is prescribed phenytoin (Dilantin) for seizure control also has a history of diabetes mellitus. Which nursing interventions would be beneficial to this patient? Select all that apply.

125

The healthcare provider has prescribed carbamazepine for seizure control in a patient also taking warfarin. Which nursing interventions would prevent complications related to concurrent use of these drugs? Select all that apply.

14

Which anticonvulsants are used to prevent migraine headaches in adults? Select all that apply.

2 and 4

Which statements are correct about anticonvulsant therapy? Select all that apply.

2.3/5

Which initial daily dosage of oxcarbazepine (Trileptal) would be anticipated for a 5-year-old child who weighs 17 kg? Select all that apply.

2/3

A registered nurse is educating practical nursing students about assessment of patients in the postictal state. Which action by a nursing student indicates a need for further instruction?

Asking a family member about any changes in the patient's behavior before the seizure

Which laboratory result would be the priority for the nurse monitoring a patient taking zonisamide (Zonegran)?

Complete blood count (CBC)

Which seizure-control medications are narrow-spectrum agents? Select all that apply.

Correct 1 Pregabalin (Lyrica) Correct 2 Tiagabine (Gabitril Correct 5 Oxcarbazepine (Trileptal) Correct 6 Carbamazepine (Tegretol

For a patient receiving carbamazepine therapy who complains of a persistent skin infection even after a course of antibiotics, which drug would the nurse anticipate was prescribed as part of the treatment regimen?

Doxycycline

Which drug is used to control absence seizures? Select all that apply.

Ethosuximide Valproic acid

A patient is currently taking clonazepam (Klonopin) and antihistamines. Which complication would the nurse expect?

Excessive sedation

Which measurement is the best indicator of how well an antiseizure medication is working?

Frequency and duration of seizures

A nurse instructs a patient taking phenytoin (Dilantin) for seizure control to follow good oral hygiene, including frequent brushing, to prevent which complication?

Gingival hyperplasia

A child who is not responding to drug therapy for the control of refractory seizures is prescribed a ketogenic diet. Which complication would the nurse expect?

High blood lipid levels

Which data would the nurse monitor in the patient with diabetes who is started on phenytoin (Dilantin) for partial seizures?

Hyperglycemia

A young adult taking phenytoin reports frequently drinking alcohol with friends. Which assessment is the priority for this patient?

Increased seizure activity

Which patient finding would the nurse expect in a patient who reports contractions of the voluntary muscles of the trunk, face, and extremities while sleeping at night?

Myoclonic seizures

After administering anticonvulsant medication, a patient develops nausea, headache, lethargy, confusion, obtundation, and malaise. Which action would the nurse immediately take to manage the patient's condition?

Notify the healthcare provider.

When evaluating the effectiveness of succinimides, for which factor does the nurse collect data?

Occurrence of petit mal seizures

In which patient is carbamazepine (Tegretol) contraindicated?

Patient with chronic hepatitis B

When a patient receiving phenytoin (Dilantin) IV develops bradycardia, which action by the nurse is appropriate to manage the patient's condition?

Stopping the bolus infusion until the heart rate returns to normal

When the patient begins treatment with lamotrigine (Lamictal), which point would the nurse provide to help the patient decrease the incidence of gastric irritation?

Taking it with milk or food

Which anticonvulsant drug increases the risk of congenital anomalies such as cleft lip or cleft palate?

Topiramate (Topamax)

Which drug would a nurse administer to a 2-year-old child who has seizures associated with Lennox-Gastaut syndrome?

Topiramate (Topamax)

Which range is appropriate for an adult dosage of clorazepate (Tranxene)?

Up to 90 mg/day

Upon reviewing the family history of an infant with a birth defect of the head, the nurse learns that the mother has a history of seizures and was taking an anticonvulsant medication during the pregnancy. Which drug may have been prescribed to the mother for seizure management?

Valproic acid (Depakene)

Which anticonvulsant medication is used as single-drug therapy for patients with a combination of generalized tonic-clonic, absence, or myoclonic seizures?

Valproic acid (Depakene)

Which order represents the correct sequence of interventions that a nurse would follow to ensure the effective care of a patient experiencing status epilepticus?

When a patient experiences status epilepticus, the nurse would provide protection and obtain assistance to transport the patient safely to an emergency facility. The nurse would then administer oxygen and attach cardiac and oxygen saturation monitors. The nurse would establish an IV line and administer IV drugs as prescribed. While administering the drugs, the nurse would monitor the patient for bradycardia, hypotension, and respiratory depression. The patient's vital signs and neurologic status should be checked next. If the patient is vomiting, the nurse would insert a nasogastric tube.

A nurse is reviewing the prescriptions of four patients with seizure disorders. Which patient does the nurse anticipate to be most likely to develop dysrhythmias?

b

When reviewing the prescriptions of four patients with a diagnosis of seizures, the nurse would identify which patient as most likely to develop pancreatitis?

c

Which term is the alternate name of atonic seizures?

drop attack

Arrange in order the events that occur during the tonic phase of seizure activity.

he tonic phase of a tonic-clonic seizure usually lasts 20 to 60 seconds. In this phase, a patient suddenly develops intense muscular contractions that lead to a fall to the ground. The patient then loses consciousness and lies rigid. After this, the patient's back may arch, the arms may flex, the legs may extend, and the teeth may clench. Because of air being forced up the larynx, saliva is extruded as foam and the patient produces an audible sound like a cry. The patient will stop breathing and may become cyanotic. Finally, the patient develops diffused trembling, transitioning into the clonic phase.

Which conditions may occur as a result of an overdose of phenytoin (Dilantin)? Select all that apply.

nystagmus hyperglycemia

Which statements are true about status epilepticus? Select all that apply.

2 It is a medical emergency that requires prompt treatment to minimize permanent nerve damage. 4 It is a rapidly recurring generalized seizure that does not allow the individual to regain normal function between seizures.

How long does the tonic phase of a tonic-clonic seizure last?

20 to 60 seconds

Which actions by a nursing student indicate a need for further education on administering diazepam (Valium)? Select all that apply.

Adding the medication to saline solution before administration Administering the medication slowly at a rate of 25 mg/min through a large vein 2,4

An IV bolus of phenytoin (Dilantin) is administered with the patient being monitored by electrocardiogram (ECG) because of the risk of which occurrence?

Bradycardia

Which drug used in the treatment of seizures requires careful monitoring of renal function?

C

Which anticonvulsant is used to treat pain associated with trigeminal neuralgia?

Carbamazepine (Tegretol)

Which antiepileptic drug is effective for almost all forms of seizures?

Valproic acid (Depakene)