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NCLEX Medications > anticonvulsant > Flashcards

anticonvulsant Flashcards

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1
Q

what are anticonvulsants meant to do?

A

given for long-term protection against seizures like with patient with epilepsy and other long term chronic seizure disorders. LONG TERM AND LAST LONGER IN THE BODY AND PATIENTS can get very toxic!

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2
Q

why is it used?

A

to manage seizure disorders and anxiety disorders

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3
Q

Klonipin

A

CLONAZEPAM

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4
Q

Valium

A

Diazepam

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5
Q

Librium

A

CHLORDIAZEPOXIDE

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6
Q

Ativan

A

Lorazepam

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7
Q

Dilantin

A

Phenytoin

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8
Q

Tegretol

A

CARBAMAZEPINE

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9
Q

Keppra

A

LEVETIRACETAM

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10
Q

LAMICTAL

A

LAMOTRIGENE

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11
Q

Common side effects of anticonvulsants:

A
  • drowsiness
  • lethargy
  • slurred speech
  • hypotension=low blood pressure
  • CNS depression
  • GINGIVAL HYPERPLASIA (NCLEX)
  • Mild skin rash or itching
  • Discolored urine light rust color
  • Hypoglycemia=LOW BLOOD SUGAR
  • Dizziness, nervousness
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12
Q

What are overdose symotoms?

A
  • twitching’s eye movements
  • loss of balance=ataxia
  • fainting
  • feeling light-headed
  • slow or shallow breathing
  • muscle stiffness or weakness
  • slurred speech
  • tremors
  • nausea and vomiting’s
  • dizziness
  • drowsiness
  • dry mouth
  • aplastic anemia
  • sleepiness
  • weakness
  • infection
  • rash
  • headache
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13
Q

Nursing implications:

A
  1. ) AVOID WITH patient that has LIVER DISEASE and DIABETES MELLITUS.
  2. ) avoid alcohol
  3. ) DO NOT CHEW OR CRUSH TABLETS= take whole
  4. ) AVOID TAKING ANTACIDS at the same time as phenytoin- it inhibits absorption.
  5. ) CARBAMAZEPINE should be taken with meals, AVOID GRAPEFRUIT JUICE.
  6. ) Monitor liver function tests
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14
Q

what should the nurse teach the patient on anticonvulsants?

A
  • TO NOT STOP THEM ABRUPTLY
  • WEAR A MEDIC ALERT BRACELET
  • REPORT EASY BRUISING
  • REPORT FEVER=high temperature
  • REPORT BLOOD IN STOOL= black tarry stools.
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15
Q

know that…

A

anticonvulsants:
-can become lethal in the body system

  • cause drowsiness
  • SHOULD NOT BE TAKEN WITH ANTACIDS AT THE SAME TIME SINCE IT DECREASES ABSORPTION so does NG tube feedings. so stop feedings 1 to 2 hours before and after administration of phenytoin.
  • can raise blood sugar
  • may change the urine color to a light rust color this is not dangerous to the patient
  • will still allow the patient to have seizure despite being on the medication.. so watch for them!
  • If your patient is on an ANVICONVULSANT initiate precautions.
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16
Q

what should be the therapeutic range for phenytoin?

A

10 to 20

17
Q

a phenytoin below 10 what to do?

A

REPORT TO THE HCP since there’s a huge risk for seizure.

18
Q

a phenytoin above 20 what do you do?

A

Hold the medication and notify HCP! Due to the huge toxicity risk!

hold the phenytoin for levels higher than 20!!

19
Q

what needs to be monitored routinely in anticonvulsants like phenytoin?

A

ROUTINE BLOOD TESTS
BLOOD LEVELS MONITORED routinely.

we do this to check the therapeutic range of the drug as well as to monitor liver function. since any drug that causes toxicity affects the liver heavily.

20
Q

when is phenytoin taken?

A

take at the same time daily= because it has a narrow therapeutic index

21
Q

early TOXICITY signs to report to the HCP about phenytoin?

A
  • ataxia (unsteady gait or gait disturbance)
  • hand tremors
  • slurred speech= having trouble forming sentences
22
Q

other adverse effects of phenytoin?

A
  1. ) suicidal ideation
  2. ) SKIN Rash that is “NEW”, “PAINFUL”= PRIORITY since it indicates Steven Johnson syndrome=REPORT TO THE HCP IMMEDIETLY.
23
Q

What are expected side effects of phenytoin or anticonvulsants?

A

1.) bradycardia=low heart rate

2.) hypotention =low blood pressure
since it is a CNS depressant meaning that we expect to the vitals will be low and slow.

3.) GINGIVAL HYPERPLASIA (NCLEX!)
overgrowth of gum tissue around the teeth resulting in big gums that bleed very easily. this is expected so do not stop the drug for this!

24
Q

what is the teaching on gingival hyperplasia?

A
  1. ) GOOD DENTAL HYGIENE with soft toothbrush
  2. ) regular dental visits and follow up care
  3. ) teach the patient to inform dentist that they are taking phenytoin
  4. ) perform or assist with other care every shift

5.) skin rash, fatigue, and dyspnea (SOB) ARE PRIORITY!!!
REMEMBER ANYTYPE OF skin rash can mean Steven Johnson syndrome.

25
Q

statements that require immediate intervention when on an anticonvulsant or phenytoin?

A
  • I noticed a rash on my stomach last week=Steven Johnson
  • lately I find myself thinking about driving off a cliff
  • If i start having adverse effects I will stop taking this medication immediately=never stop abruptly or immediately. instead always taper off
26
Q

patient teaching for phenytoin or anticonvulsant?

A
  1. ) no oral contraceptives=since it deactivates the pill and can lead to accidental pregnancies. SO WE TEACH PATIENTS TO USE ALTERNATIVE BIRTH CONTROL LIKE IUD.
  2. ) DO NOT STOP ABURTLY
  3. ) TAKE FOLIC ACID, CALCIUM, and VITAMIN D=ANTICONVULSANTS DECREASES FOLIC ACID ABSORPTION and bone density.
27
Q

what foods should be encouraged when on phenytoin or anticonvulsant?

A

encourage foods like milk, cantaloupe, and kale since they are foods high in folate and vitamin D.

28
Q

how is phenytoin administered with tube feedings?

A

tube feedings decrease the absorption of phenytoin and cause seizures so instead it is recommended:

1.) STOP TUBE FEEDINGS FOR 1 TO 2 HOURS BEFORE AND AFTER ADMINISTRATION!! mentioned multiple times as a priority!!!

2.) with tube feedings we FLUSH with 30-50 mL’s of TAP WATER BEFORE AND AFTER THE DRUG IS GIVEN!!
normal saline is not required

29
Q

how is phenytoin administered on IV insertion?

A

make sure to flush with NORMAL SALINE BEFORE AND AFTER

30
Q

Don’t let the NCLEX trick you?

A

1.) gums typically bleed= this is normal because of overgrowth of the gum tissue so please do not report this!!
But NOT THE FACE so you do not need to use an electric razor!

  1. ) NO METALLIC TASTE. But is seen in METRONIDAZOLE
  2. ) NO PHOTOSENSITIVTY
31
Q

When is LEVETIRACETAM given?

A

to prevent and treat seizures for THOSE THAT ARE AT A HIGH RISK such as:
-brain tumor
-surgery or trauma on the brain
which can increase intracranial pressure

32
Q

why is LEVETIRACETAM preferred over phenytoin?

A

due to minimal drug to drug interactions. however it is a CNS depressants just like phenytoin.

33
Q

big common side effects of LEVETIRACETAM?

A

low and slow body with:
drowsiness
fatigue

34
Q

major adverse effects for LEVETIRACETAM? and what to key words to report?

A

just like phenytoin:
-suicidal ideation

REPORT KEY WORDS like:

  • NEW ANXIETY
  • NEW AGITATION
  • DEPRESSION
  • MOOD CHANGES

-Steven Johnson syndrome

REPORT KEY WORDS like:

  • rash
  • blistering
  • muscle joint pain
  • conjunctivitis
35
Q

key points for LEVETIRACETAM? PATIENT teaching?

A

PATIENT TEACHING:
the patient needs to get PERMISSION FOR DRIVING FROM THE HCP & FOLLOW TRANSPORTATION DEPARTMENT GUIDELINES.

since LEVETIRACETAM causes DROWSINESS AND FATIGUE WHICH IS COMMON IN THE FIRST 4 TO 6 WEEKS WHEN STARING THE MEDICATION. DO NOT LET NCLEX FOOL YOU!!! ALWAYS MAKE SURE TO GET DRIVING PERMISSION.

36
Q

What permission is needed for LEVETIRACETAM?

A

get PERMISSION FOR DRIVING FROM THE HCP & FOLLOW TRANSPORTATION DEPARTMENT GUIDELINES.

NCLEX Medications (37 decks)

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