Deck 15: Drugs for Seizures

Question 1

The nurse is teaching a class for clients who have been recently diagnosed with epilepsy. The nurse determines that learning has occurred when the clients make which statements? Select all that apply.

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

Answer 1

"With some cases of epilepsy, the cause is never determined."
"A cerebral vascular accident could increase the risk for developing epilepsy."
"Epilepsy may be caused by a head injury."

Question 2

The client is receiving Phenobarbital (Nembutal) for control of seizures. The client tells the nurse she plans to become pregnant. What is the best response of the nurse?

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

Answer 2

"Please talk to your doctor; this drug is contraindicated in pregnancy."

Question 3

The client is receiving phenobarbital (Nembutal) for seizure control. The client asks the nurse how this little pill can stop his seizures. What is the best response by the nurse?

A) "Phenobarbital (Nembutal) stops your seizures by decreasing the calcium in your brain which is responsible for the seizures."
B) "Phenobarbital (Nembutal) stops your seizures by decreasing the sodium in your brain which is responsible for the seizures."
C) "Phenobarbital (Nembutal) stops your seizures by increasing a chemical called glutamate that calms down the excitability in your brain."
D) "Phenobarbital (Nembutal) stops your seizures by increasing a chemical called GABA that calms down the excitability in your brain."

Answer 3

"Phenobarbital (Nembutal) stops your seizures by increasing a chemical called GABA that calms down the excitability in your brain."

Question 4

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.

A) Monitor the client for Stevens -Johnson Syndrome.
B) Use an intravenous (IV) line with a filter.
C) Flush the intravenous (IV) line with saline.
D) Use a large vein for the infusion.
E) Monitor the client for hypertension.

Question 5

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?

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

Question 6

The physician has prescribed phenytoin (Dilantin) for a client with diabetes mellitus, type 1. What does the nurse include in the plan of care for this client?

A) Plan to discuss with the physician the need to decrease the client's insulin based on serum glucose levels.
B) Plan to discuss with the physician the need to increase the client's insulin based on serum glucose levels.
C) Plan to assess the client for petechiae, epistaxis, and hematuria.
D) Plan to institute safety precautions, as the client is at risk for dizziness and ataxia.

Question 7

The nurse has been conducting medication education for a client with epilepsy. What is the best outcome for this client?

A) The client will recognize the need to be on a tyramine -free diet while on antiseizure medications.
B) The client will recognize the need to be on antiseizure medication for one year after the last seizure.
C) The client will recognize that the antiseizure medication must be continued indefinitely.
D) The client will recognize the need to be on a ketogenic diet in combination with antiseizure medications.

Question 8

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?

A) Stevens -Johnson Syndrome.
B) Bleeding from the gums and bruising of the skin.
C) An increase in seizure activity.
D) Migraine headaches and generalized irritability.

Question 9

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?

A) "You will need medicine for a little while to cure the seizures."
B) "Having epilepsy is the same as having a mental illness; the medications are very similar."
C) "You might not need medicine; you may be controlled by a ketogenic diet."
D) "Yes, you need to take medication on a continuous basis to control the seizures".

Question 10

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. What is the best response by the nurse?

A) "Because phenytoin (Dilantin) can cause blood -thinning in some clients."
B) "Because phenytoin (Dilantin) can cause Stevens -Johnson syndrome, which will show up in the blood tests."
C) "Because phenytoin (Dilantin) has a very narrow range between a therapeutic dose and a toxic dose."
D) "Because phenytoin (Dilantin) can deplete your system of potassium."

Question 11

The young child has absence seizures. The physician has prescribed valproic acid (Depakene) syrup. The nurse has completed medication education with the child's mother and determines that learning has occurred when the mother makes which statement?

A) "I can give this on a full stomach or an empty stomach."
B) "I can still give the clonazepam (Rivotril) prescribed by the psychiatrist for sleep."
C) "I should not mix this with carbonated beverages."
D) "If my child gets a headache from this, I can administer a baby aspirin."

Question 12

The elderly client is taking phenobarbital (Nembutal) for seizure control. What is most important for the nurse to assess in the client?

A) fluid intake
B) hepatic and renal function
C) nutritional status
D) electrolyte balance

Question 13

A parent says 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?"

A) "Absence seizures are basically the same kind of seizures as grand mal, but they are less frequent."
B) "Explaining the types of seizure activity is complicated. Have you spoken to your doctor about it?"
C) "Are you sure your doctor prescribed ethosuximide (Zarontin)? Phenobarbital (Nembutal) is used much more frequently with children."
D) "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."

Question 14

The physician has ordered intravenous (IV) diazepam (Valium) for the client in status epilepticus. During administration, which assessment by the nurse is most important?

A) Assessing level of consciousness.
B) Assessing pulse for bradycardia.
C) Assessing blood pressure for hypertension.
D) Assessing respirations every 5 to 15 minutes.

Question 15

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?

A) A marked decrease in serum glucose levels will most likely occur.
B) A phenomenon known as purple gluteus syndrome will most likely occur.
C) Nothing adverse, the medication may be administered intravenously (IV) or intramuscularly (IM).
D) Local tissue damage following extravasation will most likely occur.