Deck 22: Pharmacotherapy of Seizures

Question 1

A parent says to the nurse,"The doctor prescribed ethosuximide (Zarontin)for my child,who has absence seizures.What does this mean?" Which response by the nurse is the most appropriate?

A)"Absence seizures are basically the same kind of seizures as grand mal,but they are less frequent."
B)"Your child's seizures manifest as a staring into space for a few seconds.Ethosuximide (Zarontin)is a good medication for this type of seizure."
C)"Explaining the types of seizure activity is complicated.Have you spoken to your doctor about it?"
D)"Are you sure your doctor prescribed ethosuximide (Zarontin)? Phenobarbital is used more frequently with children."

Answer 1

"Your child's seizures manifest as a staring into space for a few seconds.Ethosuximide (Zarontin)is a good medication for this type of seizure."

Question 2

The client tells the nurse that she has been prescribed phenytoin (Dilantin)for 2 years and is still having too many side effects.She wants to stop taking it.What is the best response by the nurse?

A)"This is the best medication for you; we can add another medication to decrease the side effects associated with phenytoin (Dilantin)."
B)"Please do not stop the medication abruptly,as you will have withdrawal seizures."
C)"You have probably been on the medication long enough; I'll let your doctor know you are stopping it."
D)"Side effects are a problem,but they are not as bad as the seizures you were having."

Answer 2

"Please do not stop the medication abruptly,as you will have withdrawal seizures."

Question 3

The nurse is planning educational sessions for a client regarding the use of a newly prescribed antiepileptic drug (AED).Which topics should be included in these sessions? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)The client should take the medication at the same time every day.
B)If the client forgets a dose of medication,wait until the next dose is due and take both doses together.
C)The client should take an additional dose of medication upon experiencing a seizure aura.
D)If the client experiences side effects of the medication,the client should skip the next dose to see if the side effects lessen.
E)The client should avoid using dietary supplements containing kava when on this medication.

Answer 3

The client should take the medication at the same time every day.
The client should avoid using dietary supplements containing kava when on this medication.

Question 4

The nurse completes education to the parents of a child newly diagnosed with tonic-clonic seizures.Which comments made by the parents would the nurse evaluate as indicating the need for further education? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"Some of the times when I thought he was ignoring me may have actually been seizure activity."
B)"He just needs to focus more to prevent these attacks."
C)"I know he will outgrow these seizures with time."
D)"I hope we can help our son identify his seizure aura."
E)"We will watch for the development of status epilepticus."

Question 5

A preschool-age client is diagnosed with epilepsy.The child's mother is crying as she tells the nurse,"I know that this is my fault.I did drugs before I knew I was pregnant." Which response by the nurse is the most appropriate?

A)"That is most likely not the reason your child has epilepsy."
B)"The most important thing now is getting good care for your child."
C)"Women who take drugs during pregnancy have to realize they are possibly hurting their baby."
D)"Medical testing can tell when the damage occurred."

Question 6

The elderly client is prescribed phenobarbital for seizure control.What is most important intervention for the nurse to add to the client's care plan?

A)Monitor for signs of electrolyte imbalance.
B)Assess respiratory rate and depth every hour.
C)Track nutritional intake.
D)Measure and record all fluid intake and output.

Question 7

The client is receiving carbamazepine (Tegretol)for control of seizures.The client tells the nurse she plans to become pregnant.Which response by the nurse is the most appropriate?

A)"Please talk to your doctor; this drug is contraindicated in the pregnancy."
B)"Your medication dose will need to be decreased during your pregnancy."
C)"Your medication dose will need to be increased during your pregnancy."
D)"Please talk to your doctor; you will need a safer drug like valproic acid (Depakene)."

Question 8

The parents of a pediatric client diagnosed with epilepsy have decided to try a ketogenic diet to control their child's epilepsy.Which food should the nurse teach these parents to include in their child's diet?

A)Mashed potatoes with gravy
B)Baked chicken
C)Salad with vinegar and oil dressing
D)Roast beef

Question 9

The health care provider has prescribed 5 mg of intravenous diazepam (Valium)to treat the client in status epilepticus.The client's IV bag is labeled "1,000 mL D5NS with 20,000 units Heparin." Which nursing interventions are necessary to safely administer this diazepam (Valium)? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Use a large bore needle to access the IV port.
B)Flush the intravenous (IV)line with saline.
C)Administer the diazepam (Valium)directly into a vein in the client's hand.
D)Dilute the diazepam (Valium)with xylocaine prior to administration.
E)Observe the IV tubing for cloudiness while administering the diazepam (Valium).

Question 10

The client is prescribed phenobarbital for seizure control.The client asks the nurse how this little pill can stop seizures.What response by the nurse is the most appropriate?

A)"The pill helps to decrease the calcium in your brain,which is responsible for your seizures."
B)"This medication increases a chemical called GABA that calms down the excitability in your brain that causes your seizures."
C)"Phenobarbital increases a chemical called glutamate,which calms down the excitability in your brain that causes your seizures."
D)"It helps by decreasing the sodium in your brain,which is responsible for the seizures."

Question 11

A parent tells the nurse,"The doctor says my son has epilepsy,but he has never had a convulsion.How can that be?" Which response by the nurse to the parent is the most appropriate?

A)"He will probably develop convulsions as he gets older."
B)"Some epileptics do not have seizures."
C)"Convulsions are not part of all epileptic conditions."
D)"The convulsions common in young boys are usually silent."

Question 12

The health care provider has ordered intravenous (IV)diazepam (Valium)for the client in status epilepticus.During administration,it is most important for the nurse to assess for which result from this drug?

A)Tachycardia
B)Level of consciousness
C)Hypotension
D)Respiratory depression

Question 13

The client who is prescribed valproic acid (Depakote)for seizure control would like to have a baby.Which statements should the nurse include in a discussion with this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"Since your epilepsy may flare up during pregnancy,your doctor will likely have you take a second antiepileptic medication."
B)"Thankfully,most modern antiepileptic medications will not interfere with your getting pregnant."
C)"Your current antiepileptic medication should not be used when you are pregnant."
D)"Folic acid supplementation is important for you."
E)"You should consider adopting a baby instead since there are so many problems associated with epilepsy and pregnancy."

Question 14

A mother phones the clinic and tells the nurse,"My 5-year-old son had a fever seizure this morning." She adds that this is the child's first seizure experience.The nurse responds by asking the mother to bring the child in to be seen today.What other information should the nurse offer? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"Febrile seizures are uncommon in boys."
B)"High temperatures generally induce seizures."
C)"Five-year-olds are too old for febrile seizures."
D)"Febrile seizures occur in up to 5% of children."
E)"Seizure medications are usually not necessary for febrile seizures."

Question 15

The nurse is talking with a client who was just prescribed zonisamide (Zonegran).Which client statement should the nurse immediately discuss with the client's health care provider? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"Did I mention that I used to take phenobarbital for my seizures?"
B)"I forgot to tell the doctor that I am allergic to sulfa drugs."
C)"I have lactose intolerance,so I can't drink milk."
D)"My husband and I plan to have a baby in a couple of years."
E)"My husband and I are leading a 20-mile bicycle tour next weekend for the company we have just started."

Question 16

The nurse is speaking before a group of elementary school teachers on the topic of seizure control medications.Which behaviors should the nurse advise the teachers to watch for in children who are taking levetiracetam (Keppra)? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Sleepiness after lunch
B)Fighting at recess
C)Inability to sit still
D)Tearfulness
E)Difficulty in seeing the blackboard

Question 17

The client says to the nurse,"My doctor said that I will always have to take medicine to control the seizures from my epilepsy.Is that so?" What is the best response by the nurse?

A)"You will need to take medication on a continuous basis to control the seizures."
B)"You will have to take the medication until your seizures are cured."
C)"You will need to take the medication unless you are willing to make some very difficult lifestyle changes."
D)"After you have been seizure free for 1 year,you can stop taking medication."

Question 18

The client has epilepsy and is prescribed phenytoin (Dilantin).The client has been seizure free and asks the nurse why he still needs blood tests when he is not having seizures.Which response by the nurse is the most appropriate?

A)"Dilantin can cause blood thinning in some people."
B)"There is a narrow range between a helpful dose of this medication and a dose that could make you feel sicker."
C)"Dilantin tends to lower blood levels of potassium."
D)"This medication can cause a severe skin reaction called Steven-Johnson syndrome if doses are too high."

Question 19

An emergency department (ED)client's wife says,"I couldn't wake my husband up this morning.He was snoring so loudly.Why,he was so asleep he urinated in the bed.He has never done anything like this before and he is okay now." Which the priority for the nurse to ask the client's wife?

A)"Does your husband have diabetes?"
B)"Was your husband especially active yesterday?"
C)"Has your husband ever had a seizure?"
D)"What kind of street drugs did your husband take last night?"

Question 20

The nurse is teaching a class for clients who recently have been diagnosed with epilepsy.The nurse determines that learning has occurred when the clients make which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"Epilepsy can be caused by a head injury."
B)"With some cases of epilepsy,the cause is never determined."
C)"Excessive stress levels cause disruptions in how the brain receives oxygen,leading to epilepsy."
D)"Eating disorders like anorexia nervosa increase the risk for developing epilepsy."
E)"A stroke,or brain attack,could increase the risk for developing epilepsy."

Question 21

The client is prescribed valproic acid (Depakene)for treatment of seizures.The client has also been taking a daily 81 mg aspirin tablet prophylactically for a cardiac condition.Because of the use of these two drugs,the nurse closely observes the client for which occurrence?

A)Increase in seizure activity
B)Migraine headaches and generalized irritability
C)Bleeding from the gums and bruising of the skin
D)Stevens-Johnson syndrome

Question 22

The client states,"I can't swallow those capsules," so the nurse plans to open the carbamazepine (Carbitrol)for administration.Which foods found on the client's lunch tray are appropriate for the nurse to use for administration of this medication? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)A hamburger patty
B)Citrus salad
C)Applesauce
D)Mashed potatoes
E)Green beans