Deck 26: Pharmacotherapy of Seizures

Question 1

The physician has ordered intravenous phenytoin (Dilantin).The client is also receiving 5% dextrose in water (D5W)intravenously (IV).What will the nurse plan to do before administering this medication? Select all that apply.
1)Flush the intravenous (IV)line with saline.
2)Monitor the client for hypertension.
3)Use an intravenous (IV)line with a filter.
4)Use a large vein for the infusion.
5)Monitor the client for Stevens-Johnson syndrome.

Answer 1

1, 3, 4

Question 2

The physician has prescribed diazepam (Valium)syrup for an 8-year-old with seizure disorders.The nurse has completed medication education with the child's mother, and determines that learning has occurred when the mother makes which statement?
1)"I can give this on a full stomach or an empty stomach."
2)"If my child gets a headache from this, I can administer a baby aspirin."
3)"I should not mix this with grapefruit juice."
4)"I can still give the clonazepam (Klonopin)prescribed by the psychiatrist for sleep."

Answer 2

3

Question 3

The physician has ordered intravenous (IV)phenytoin (Dilantin).The nurse does not read the drug label and administers the medication intramuscularly (IM).What is the most likely response in the client?
1)Nothing adverse, the medication may be administered intravenously or intramuscularly.
2)A phenomenon known as purple gluteus syndrome most likely will occur.
3)A marked decrease in serum glucose levels most likely will occur.
4)Local tissue damage following extravasation most likely will occur.

Answer 3

4

Question 4

The client tells the nurse that she has been taking phenytoin (Dilantin)for two years now, and is still having too many side effects.She wants to stop taking it.What is the best response by the nurse?
1)"This is the best medication for you; we can add another medication to decrease the side effects associated with phenytoin (Dilantin)."
2)"You have probably been on the medication long enough; I'll let your doctor know you are stopping it."
3)"Side effects are a problem, but they are not as bad as the seizures you were having."
4)"Please do no stop the medication abruptly, as you will have withdrawal seizures."

Question 5

The physician has prescribed phenytoin (Dilantin)for a client with diabetes mellitus who presents with partial seizures.What does the nurse include in the care plan for this client?
1)Plan to institute safety precautions, as the client is at risk for dizziness and ataxia.
2)Plan to discuss with the physician the need to increase the client's insulin based on serum glucose levels.
3)Plan to assess the client for petechiae, epistaxis, and hematuria.
4)Plan to discuss with the physician the need to decrease the client's insulin based on serum glucose levels.

Question 6

The client is receiving phenobarbital (Luminal)for control of seizures.The client tells the nurse she plans to become pregnant.What is the best response of the nurse?
1)"Your medication dose will need to be increased during your pregnancy."
2)"Please talk to your doctor; this drug is contraindicated in the pregnancy."
3)"Your medication dose will need to be decreased during your pregnancy."
4)"Please talk to your doctor; you will need a safer drug like valproic acid (Depakene)."

Question 7

The elderly client is taking phenobarbital (Luminal)for seizure control.What is most important for the nurse to assess in the client?
1)Respiratory function
2)Nutritional status
3)Fluid intake
4)Electrolyte balance

Question 8

The client says to the nurse, "My doctor said I have epilepsy and need to take medicine for those seizures I had.Do I really need medicine?" What is the best response by the nurse?
1)"You will need medicine for a little while to cure the seizures."
2)"You might not need medicine; the seizures possibly could be controlled by a ketogenic diet."
3)"Having epilepsy is the same as having a mental illness; the medications are very similar."
4)"Yes, you need to take medication on a continuous basis to control the seizures."

Question 9

The nurse has been conducting medication education for a client with epilepsy.What is the best outcome for this client?
1)The client will state that the anti-seizure medication must be continued indefinitely.
2)The client will state the need to be on anti-seizure medication for one year after the last seizure.
3)The client will state the need to be on a single type of anti-seizure medication.
4)The client will state the need to be on a tyramine-free diet while on anti-seizure medications.

Question 10

A parent says to me to the nurse, "The doctor prescribed ethosuximide (Zarontin)for my child, who has absence seizures.What does this mean?" What is the best response by the nurse?
1)"Your daughter's seizures manifest as a staring into space for a few seconds.Ethosuximide (Zarontin)is a good medication for this type of seizure."
2)"Absence seizures are basically the same kind of seizures as grand mal, but they are less frequent."
3)"Are you sure your doctor prescribed ethosuximide (Zarontin)? Phenobarbital (Luminal)is used more frequently with children."
4)"Explaining the types of seizure activity is complicated.Have you spoken to your doctor about it?"

Question 11

The client is receiving phenobarbital (Luminal)for seizure control.The client asks the nurse how this little pill can stop his seizures.The nurse is aware that phenobarbital (Luminal)stops seizures by:
1)Increasing a chemical called glutamate that calms down the excitability in the brain.
2)Decreasing the sodium in the brain, which is responsible for the seizures.
3)Decreasing the calcium in the brain, which is responsible for the seizures.
4)Increasing a chemical called GABA that calms down the excitability in the brain.

Question 12

The physician has ordered intravenous (IV)diazepam (Valium)for the client in status epilepticus.During administration, which assessment by the nurse is most important?
1)Hypotension
2)Respiratory depression
3)Tachycardia
4)Level of consciousness

Question 13

The client has epilepsy, and receives phenytoin (Dilantin).The client has been seizure-free, and asks the nurse why he still needs blood tests when he is not having seizures.The nurse is aware the phenytoin (Dilantin)can:
1)Deplete potassium.
2)Cause Steven-Johnson syndrome.
3)Have a narrow range between a therapeutic dose and a toxic dose.
4)Cause blood thinning in some clients.

Question 14

The client is receiving valproic acid (Depakene)for treatment of seizures.The client has also been taking a daily 81 mg aspirin tablet prophylactically for a cardiac condition.What would the nurse be most likely to observe?
1)An increase in seizure activity
2)Stevens-Johnson syndrome
3)Bleeding from the gums and bruising of the skin
4)Migraine headaches and generalized irritability

Question 15

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? Select all that apply.
1)"Eating disorders, like anorexia nervosa, increase the risk for developing epilepsy."
2)"Epilepsy can be caused a head injury."
3)"Excessive stress levels cause disruptions in how the brain receives oxygen, leading to epilepsy."
4)"With some cases of epilepsy, the cause is never determined."
5)"A stroke, or brain attack, could increase the risk for developing epilepsy."