Question 1

For which condition may carbamazepine (Tegretol) be used?

Accepted Answer

Carbamazepine (Tegretol) is commonly used to treat trigeminal neuralgia pain.

Question 2

Which is the drug of choice when treating a generalized tonic-clonic seizure?

Accepted Answer

Valproic acid (Depakene) is the drug of choice for a generalized tonic-clonic seizure. It is effective in preventing future seizures and can be administered orally or intravenously. Diazepam (Valium) may also be used to stop an ongoing seizure but is not recommended for long-term management due to the risk of dependence and tolerance. Haloperidol (Haldol) and Risperidone (Risperdal) are antipsychotic medications and are not indicated for the treatment of seizures.

Question 3

The nurse is providing education to a patient recently prescribed pregabalin (Lyrica). Which statement by the patient indicates a need for further instruction?

Accepted Answer

The statement "Once my pain improves, I will stop taking this medication" indicates a need for further instruction. Pregabalin should not be abruptly discontinued, and the patient should follow the prescribed regimen even if their pain has improved.

Question 4

Which is a guideline for the nurse when administering phenytoin (Dilantin) intravenously?

Accepted Answer

Phenytoin (Dilantin) should not be mixed with other medications due to possible incompatibilities. It should be administered slowly (no faster than 50 mg/minute) to prevent adverse reactions such as hypotension and cardiac arrhythmias. The nurse should also monitor for signs of extravasation and assess for respiratory depression. Hypertensive crisis and tachycardia are not commonly associated with phenytoin administration.

Question 5

Which response by the nurse is accurate when a patient who has been on lamotrigine (Lamictal) for seizure control reports a skin rash and urticaria?

Accepted Answer

A skin rash and urticaria are common adverse effects of lamotrigine (Lamictal), and it is important to report these symptoms to the health care provider. However, it is not recommended to discontinue the medication abruptly, as this can lead to rebound seizures or other serious complications. Decreasing the dosage may also not be appropriate without medical guidance. Therefore, the best approach is to advise the patient to report the symptoms to the provider and continue taking the medication as prescribed until further instruction. The provider may then adjust the dosage or switch to an alternative medication as needed.

Question 6

The health care provider orders diazepam (Valium) 10 mg IV stat for a patient who was admitted with status epilepticus. What are important nursing considerations associated with administration of this medication IV? (Select all that apply.)

Accepted Answer

Continuous cardiac monitoring is important due to potential cardiovascular effects. The patient's airway should be continuously assessed due to the risk of respiratory depression. Diazepam should be administered as a slow IV push to avoid complications.

Question 7

Which dose is within the acceptable range for administering IV phenytoin (Dilantin) to a patient with a seizure disorder?

Accepted Answer

The answer of Which dose is within the acceptable range...

Question 8

Which premedication assessment by the nurse is most important prior to the initiation of carbamazepine (Tegretol) therapy?

Accepted Answer

Carbamazepine can cause serious skin reactions, especially in patients of Asian descent with the HLA-B*1502 allele. Determining the patient's ancestry helps assess the risk for these reactions.

Question 9

Which condition is associated with hydantoin therapy?

Accepted Answer

Gingival hyperplasia is a common side effect of hydantoin therapy.

Question 10

Patients taking phenytoin (Dilantin) for control of seizures must be aware of the risk for which of the following adverse effects? (Select all that apply.)

Accepted Answer

Phenytoin can cause blood dyscrasias, hyperglycemia, gingival hyperplasia, and sedation as adverse effects.

Question 11

Which condition would indicate to the nurse that a patient has phenytoin (Dilantin) toxicity?

Accepted Answer

Nystagmus is an indication of phenytoin (Dilantin) toxicity. Other symptoms include ataxia, confusion, and slurred speech. Oculogyric crisis, strabismus, and amblyopia are not typically associated with phenytoin toxicity.

Question 12

Which information would be most important for the nurse to provide to a patient when teaching about the adverse effects of succinamide therapy?

Accepted Answer

Nausea, vomiting, and indigestion are common adverse effects when starting succinamide therapy, and patients should be informed about these potential side effects.

Question 13

The nurse is preparing discharge instructions for a patient with a history of diabetes who has just been diagnosed with seizure disorder. The patient has been prescribed hydantoin therapy. Which will the patient most likely experience?

Accepted Answer

Hydantoin therapy, such as phenytoin, can cause hyperglycemia as a side effect due to its impact on insulin secretion and glucose metabolism.

Question 14

Which medication is used to control seizures or prevent migraine headaches?

Accepted Answer

The answer of Which medication is used to control seizures...

Question 15

What is included in the nursing management of the patient with generalized tonic-clonic seizure activity? (Select all that apply.)

Accepted Answer

Restraining the patient's arms can cause injury, and attempting to insert a tongue depressor can cause more harm than good. Instead, padding around and under the patient's head can prevent head injury during the seizure. Once the relaxation stage is entered, positioning the patient on their side can prevent aspiration and allow oral secretions to drain. Requesting additional assistance and equipment is important in case the patient does not begin breathing spontaneously after the seizure.

Question 16

The nurse is providing discharge teaching to a patient prescribed phenytoin (Dilantin) for management of a seizure disorder. Which patient statement indicates a need for further teaching?

Accepted Answer

Enlarged gums (gingival hyperplasia) are a side effect of phenytoin and should be reported to the healthcare provider, but stopping the medication abruptly can result in rebound seizures. The patient should never discontinue the medication without consulting the healthcare provider. The other statements are accurate and indicate good understanding of the medication and its use.

Quiz 19: Drugs Used for Seizure Disorders