Chapter 25 Book Qs & Evolve Qs

Question 1

2. Which side effects are common with first-line drugs used to treat partial and generalized seizures? (Select all that apply.)

A. Dizziness B. Constipation C. Hypotension D. Sedation E. Rashes F. Nausea

Answer 1

A C D F

Question 2

3. A patient is prescribed an IV dose of phenytoin (Dilantin). Which solution should be used to dilute this drug?

A. 5% dextrose B. 5% dextrose with 0.45 saline C. 0.9% normal saline D. Lactated ringer’s solution

Answer 2

C

Question 3

4. A patient tells you that his seizure activity has increased over the past month. What important teaching point will you stress with this patient?

A. “You should take an extra dose of your antiseizure medication each day.” B. “You must go to the lab to have some blood tests done.” C. “You need to contact your prescriber whenever seizures increase or change.” D. “You should not worry about this because stress can cause increased seizures.”

Answer 3

C

Question 4

5. A child is prescribed phenytoin (Dilantin) for a seizure disorder. What precaution should you discuss with the parents?

A. Be sure to take your child to see a dentist regularly. B. Always give this drug on an empty stomach. C. Administer the phenytoin within 30 minutes after an antacid. D. Report any facial swelling due to the risk for angioedema.

Answer 4

A

Question 5

6. Which drug used to treat seizures decreases impulse transmission by affecting sodium channels in neurons?

A. phenobarbital (Luminal) B. carbamazepine (Tegretol) C. valproic acid (Depakote) D. phenytoin (Dilantin)

Answer 5

B

Question 6

7. For which adverse effects must you watch after giving a patient phenytoin (Dilantin)? (Select all that apply.)

A. Neutropenia B. Stevens-Johnson syndrome C. Aplastic anemia D. Thrombocytopenia E. Pancreatitis

Answer 6

A, B, C

Question 7

8. What safety intervention must you take when giving the first-line drug for seizures phenytoin (Dilantin) by the intravenous (IV) route?

A. Make sure that the IV catheter is 18 gauge or larger. B. Question the order because this drug is not given IV. C. Ensure that the IV solution infusing is normal saline. D. Place a padded tongue blade at the patient’s bedside.

Answer 7

C

Question 8

9. A patient is taking carbamazepine (Tegretol). What must you be sure to teach the patient about this drug?

A. Visit a dentist regularly. B. You may experience delayed healing and increased risk of infection. C. Always take the drug on an empty stomach. D. Wear protective clothing and a strong sunscreen.

Answer 8

D

Question 9

10. Which is an important consideration when administering first-line drugs for absence seizures to growing children?

A. They may develop high fevers. B. They will have a higher incidence of rashes. C. They may develop hostile, aggressive behavior. D. They may need dose increases.

Answer 9

D

Question 10

11. A patient has been prescribed phenobarbital (Luminal) 300mg per day. The pharmacy sent 100mg tablets. How many tablets do you give with each dose? _____ tablets

Answer 10

3 tablets

Question 11

12. A 4-year-old child is to be given phenytoin (Dilantin) 5mg/kg/day in two divided doses. The child weighs 20kg. How many milligrams do you give for each dose? _____ mg/dose

Answer 11

50 mg/dose

Question 12

The nurse is caring for a patient admitted with a diagnosis of seizures. The nurse knows that an “epileptic cry” is common with what type of seizure?

Answer 12

Tonic-clonic

Question 13

A patient who experienced a seizure states, “I saw white floating lights before the seizure.” What occurrence is the patient referring to?

Answer 13

Aura

Question 14

A patient was just brought in by ambulance to the emergency department (ED) after having several seizures at home. What actions should be taken if the patient experiences status epilepticus?

Answer 14

Actions for treating this life-threatening condition include protecting the airway, providing oxygen, establishing intravenous (IV) access to give 5 to 10 mg of diazepam (Valium) by slow IV injection, and determining and treating the cause. To protect the patient from injury remove anything that could cause injury to the patient and turn him or her to one side to prevent aspiration and let secretions drain. Padded tongue blades should never be put into the mouth of patient after a seizure begins. Not only may the jaw clench as soon as the seizure starts, but it could also cause damage to the teeth and aspiration of tooth fragments. Incorrect tongue blade placement can also cause airway obstruction.

Question 15

The nurse is caring for a patient with a diagnosis of idiopathic (no known cause) seizures. What are some factors associated with this type of seizures?

Answer 15

Family history of seizures present

Question 16

A newly admitted patient has just been diagnosed with seizures and asks the nurse what can cause them. The nurse tells the patient that during what times is a person with a seizure disorder most at risk for having a seizure?

Answer 16

When a person has a seizure disorder, seizures are more likely to occur during periods of increased emotional or physical stress. Risk factors associated with worsening of a well-controlled seizure disorder include pregnancy and lack of sleep, not sleeping soundly.

Question 17

What are the most common causes of seizures in children? (select all that apply)

tumors 
fever
central nervous system infections
hypoxia
electrolyte imbalances.

Answer 17

All besides tumors.

Tumors and stroke are a common cause of seizures in adults. For children, a common cause of seizures includes fever, central nervous system infections, hypoxia, and electrolyte imbalances.

Question 18

A patient with a history of seizures has just been admitted. What actions should you take if the patient experiences a tonic-clonic seizure?

Answer 18

During a tonic-clonic seizure, actions taken include protecting from injury, protecting the airway, and documenting the length and time the seizure started. For a generalized or complex partial seizure, remove anything that could cause injury to the patient and turn him or her to one side to prevent aspiration and let secretions drain. Establishing IV access would be a measure to take for status epilepticus. Administering diazepam would be a measure to take for status epilepticus. Padded tongue blades should never be put into the mouth of patient after any seizure begins. Not only may the jaw clench as soon as the seizure starts, but it could also cause damage to the teeth and aspiration of tooth fragments. Incorrect tongue blade placement can also cause airway obstruction.

Question 19

A patient who is taking antiseizure medications develops GI symptoms. What would you suggest to the patient?

Answer 19

take w/ food

Question 20

absence seizures cab only last a few seconds. t/f

Answer 20

T

Question 21

The nurse is admitting a patient with a history of seizures who is taking phenytoin (Dilantin). The nurse knows that what factor requires patients who are taking Dilantin to see their dentist regularly?

Answer 21

Extra growth of gums.

Phenytoin (Dilantin) can cause extra growth of gum tissues. Tell patients to visit their dentist regularly and to brush and floss teeth carefully. Patients who take phenytoin do not have a greater risk for cavities, oral cancer, or gingivitis.