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STUVIA 2024/2025Chapter 19: Antiseizure Drugs
ANS: A
Anticonvulsants are given to prevent seizures and are usually taken throughout the patient's lifetime.
Stopping the medication can lead to recurrence of seizures in most patients. Some patients may
attempt to stop taking the medications after 3 to 5 years of no seizure activity. Anticonvulsants are not
given as needed. - ✔✔A patient who has epilepsy will begin an anticonvulsant medication. The
patient asks the nurse how long the medication will be necessary. How will the nurse respond?
a. "The medication may be necessary for a lifetime."
b. "The medication will be given until you are seizure free."
c. "You will need to take the medication for 3 to 5 years."
d. "You will take the medication as needed for seizure activity."
ANS: A
Chronic ingestion of alcohol increases hydantoin metabolism, which would decrease serum drug
levels. The therapeutic range is 10 to 20 mcg/mL, so a level lower than this may be expected in
patients who consume alcohol regularly. - ✔✔A patient who takes phenytoin reports regular alcohol
consumption. The nurse might expect a serum phenytoin level in this patient to be in which range?
%
a. 5 to 10 mcg/mL
b. 10 to 20 mcg/mL
c. 20 to 30 mcg/mL
d. 30 to 50 mcg/mL
ANS: A
Diazepam is given to patients in status epilepticus and is administered IV. The drug has a short-term
effect; other antiseizure drugs, such as phenytoin or phenobarbital, must be given during or
immediately after administration of diazepam. The other anticonvulsant medications do not have a
rapid onset and are not used for emergencies. - ✔✔An intubated child is brought to the emergency
department while having a seizure that has been progressing for 20 minutes. Which drug will the
nurse anticipate administering to this patient first?
a. Diazepam (Valium)
b. Phenobarbital (Luminal)
c. Phenytoin (Dilantin)
d. Valproic acid (Depakote)
ANS: A
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, STUVIA 2024/2025
Intravenous phenytoin should be administered undiluted through a 3-way stopcock or Y-tubing. In
older patients it should be infused at a rate of 25 mcg/min. The dose and the route are appropriate.
Phenytoin will precipitate in dextrose solution. Intramuscular injection is very irritating to tissues and is
not used. - ✔✔The nurse is preparing to administer phenytoin to an 80-year-old patient and notes
the following order: IVP phenytoin 50 mg. The nurse will perform which action?
a. Administer the undiluted drug through a Y-tube over 2 minutes.
b. Contact the provider to question the route and the dose.
c. Dilute the drug in dextrose solution and infuse over 15 to 20 minutes.
d. Request an order to administer the drug intramuscularly.
ANS: A
Patients who have taken hydantoins for long periods might have an elevated blood sugar that results
from the drug inhibiting the release of inulin. The nurse should discuss this test with the provider. -
✔✔The nurse is preparing to assist with blood collection on a newly admitted patient who has been
taking phenytoin for several years. The provider has ordered a complete blood count and liver
function tests. Which other blood test will the nurse discuss with the provider?
a. Blood glucose
b. Coagulation studies
c. Renal function tests
%
d. Serum electrolytes
ANS: A
Phenytoin commonly causes gingival hyperplasia, which causes overgrowth of reddened gum tissue
that bleeds easily. It is not a sign of a drug interaction (there is no known interaction between
phenytoin and aspirin) or a symptom of hepatotoxicity. It does not indicate a lack of self-care. -
✔✔The nurse is caring for a patient who has a seizure disorder being treated with phenytoin. The
nurse notes that the patient has reddened gums that bleed when brushing. The nurse recognizes this
finding as:
a. an adverse effect of the phenytoin.
b. likely due to a drug interaction with aspirin.
c. a symptom of hepatotoxicity.
d. a sign of poor self-care.
ANS: A
The patient's drug level is considered normal, since 10 to 20 mcg/mL is the therapeutic range. The
nurse should administer the dose. It is not necessary to decrease the dose or monitor the patient
more closely than usual. - ✔✔The nurse is preparing to administer phenytoin (Dilantin) to a patient
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