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.

Accepted Answer

Phenytoin (Dilantin) is not compatible with dextrose solutions, so the IV line should be flushed with saline before and after administration to prevent precipitation. A filter is recommended to remove any precipitate that may form when the drug is mixed with IV fluids. Using a large vein can help reduce the risk of phlebitis and ensure the medication is diluted properly as it enters the circulation.

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?

Accepted Answer

Diazepam (Valium) can interact with grapefruit juice, leading to increased blood levels of the medication and potentially increasing side effects. The mother's understanding to avoid mixing the medication with grapefruit juice indicates that learning has occurred.

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?

Accepted Answer

Phenytoin (Dilantin) is intended for intravenous (IV) use, and administering it intramuscularly (IM) can lead to local tissue damage due to the drug's irritating properties when it is not delivered into the vein as prescribed.

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?

Accepted Answer

Abruptly stopping phenytoin (Dilantin), an antiepileptic drug, can lead to withdrawal seizures. It's important for patients to consult their healthcare provider before making any changes to their medication regimen.

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?

Accepted Answer

Phenytoin can affect blood glucose levels, potentially leading to hyperglycemia, so the nurse should monitor glucose levels and discuss with the physician the need to adjust insulin dosage.

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?

Accepted Answer

Phenobarbital is contraindicated in pregnancy due to the risk of fetal harm. It is important for the client to discuss with her doctor for a safer alternative.

Question 7

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

Accepted Answer

Phenobarbital can depress the central nervous system, leading to respiratory depression, which is a critical side effect to monitor, especially in elderly clients who may be more susceptible to this effect.

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?

Accepted Answer

Epilepsy is a chronic condition characterized by recurrent seizures, and medication is often required on a continuous basis to control these seizures. Unlike some conditions that might be cured or significantly improved with short-term medication, epilepsy typically requires long-term management. Options like the ketogenic diet may help in some cases, but medication remains a cornerstone of treatment for most individuals with epilepsy.

Question 9

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

Accepted Answer

The best outcome for a client with epilepsy is understanding that anti-seizure medication often needs to be continued indefinitely to manage the condition effectively. This is because epilepsy is typically a chronic condition, and ongoing medication is necessary to prevent seizures.

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?

Accepted Answer

Ethosuximide (Zarontin) is specifically indicated for absence seizures, which are characterized by brief, sudden lapses in attention or staring spells. This type of seizure does not involve the convulsions seen in more widely recognized seizures like tonic-clonic (grand mal) seizures. Therefore, the nurse's explanation in choice A accurately describes the nature of absence seizures and the appropriateness of ethosuximide for treating them.

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:

Accepted Answer

Phenobarbital (Luminal) works by increasing the action of GABA, a neurotransmitter in the brain that has inhibitory effects on neuronal excitability, thus calming down the brain and preventing seizures.

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?

Accepted Answer

Respiratory depression is the most critical assessment when administering intravenous diazepam, as it can depress the central nervous system, leading to decreased respiratory function. This is a significant risk, especially in a rapid IV administration scenario like status epilepticus.

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:

Accepted Answer

Phenytoin (Dilantin) has a narrow therapeutic index, meaning there is a small range between the dose that is effective and the dose that can be toxic. Regular blood tests are necessary to ensure the drug levels remain within this safe and effective range, even if the patient is not currently experiencing seizures. This monitoring helps prevent toxicity while ensuring the medication's efficacy.

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?

Accepted Answer

Valproic acid can increase the effects of aspirin on platelet aggregation, leading to an increased risk of bleeding. Therefore, the nurse would most likely observe signs of bleeding such as bleeding from the gums and bruising of the skin.

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.

Accepted Answer

B) Head injuries can damage brain tissue and lead to epilepsy, making this a correct statement.D) In many cases of epilepsy, the exact cause remains unknown, which is acknowledged in medical literature.E) Strokes can cause brain damage that may result in epilepsy, making this statement accurate.

Quiz 26: Pharmacotherapy of Seizures

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.

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?

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?

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?

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?

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?

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

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?

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

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?

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:

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

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:

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?

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.