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Chapter 12: Anticonvulsant Drugs and Drugs to Treat Epilepsy, Migraine Headaches, and Intracranial Emergencies

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Chapter 12: Anticonvulsant Drugs and Drugs to Treat Epilepsy, Migraine Headaches, and Intracranial Emergencies

10 problems · 0 figures

12-1 §12.RQ source ↗

A nurse is caring for a client who is receiving mannitol. Which of the following interventions should the nurse provide for the client?
  1. a.
    Elevate the head of the bed to 30 degrees and keep the client’s head at a neutral position.
  2. b.
    Place the client in a supine position with the head turned to the right side.
  3. c.
    Elevate the head of the bed 90 degrees and keep the client’s head at a neutral position.
  4. d.
    Place the client in a supine position with the head turned to the left side.

Answer

A. Elevate the head of the bed to 30 degrees and keep the client’s head at a neutral position.
Mannitol is administered for cerebral edema and increased intracranial pressure. Elevating the head of the bed to a 30-degree angle and keeping the client’s head in a neutral position helps to decrease intracranial pressure.

12-2 §12.RQ source ↗

A nurse is preparing to administer valproic acid 300 mg orally twice daily. Available is valproic acid 250 mg/5 mL. How many milliliters should the nurse administer per dose? Round to the nearest whole number.
  1. a.
    4 mL
  2. b.
    5 mL
  3. c.
    6 mL
  4. d.
    7 mL

Answer

C. 6 mL
300 mg x mL desired dose = 250 mg 5 mL supply on hand
250 x = 300 ( 5 ) x = 1500 250 x = 6 mL per dose .

12-3 §12.RQ source ↗

A nurse is teaching a female client diagnosed with migraine headaches about a new prescription for sumatriptan. Which of the following instructions should the nurse include?
  1. a.
    Take this medication every day to prevent migraine headaches.
  2. b.
    Use contraception while taking this medication.
  3. c.
    Take the drug every 30 minutes until the migraine headache subsides.
  4. d.
    Monitor blood pressure every 2 hours while taking this medication.

Answer

B. Use contraception while taking this medication.
Sumatriptan is contraindicated in pregnancy, and contraception should be taken while on this drug.

12-4 §12.RQ source ↗

A nurse is assessing a client who is receiving valproic acid. What therapeutic response does the nurse expect to see from valproic acid?
  1. a.
    Decreased seizure activity
  2. b.
    Reduced intracranial hypertension
  3. c.
    Improved migraine headache
  4. d.
    Decreased intracranial pressure

Answer

A. Decreased seizure activity
Valproic acid is a valproate, which is used in the treatment of seizures and as a mood stabilizer.

12-5 §12.RQ source ↗

A nurse is preparing to administer phenytoin 70 mg bolus to a client with a seizure disorder. The drug is supplied as a 50 mg/mL vial. How many milliliters should the nurse administer? Round to the nearest tenth.
  1. a.
    1.25 mL
  2. b.
    1.4 mL
  3. c.
    1.55 mL
  4. d.
    1.6 mL

Answer

B. 1.4 mL
70 mg x mL desired dose = 50 mg 1 mL supply on hand
50 x = 70 ( 1 ) x = 70 50 x = 1.4 mL per dose .

12-6 §12.RQ source ↗

A client is prescribed ethosuximide for seizures. Which of the following adverse effects should the nurse monitor the client for?
  1. a.
    Increased energy
  2. b.
    Constipation
  3. c.
    Sleeplessness
  4. d.
    Rash

Answer

D. Rash
Rash is an adverse effect of ethosuximide.

12-7 §12.RQ source ↗

Which of the following statements is true about migraine headaches?
  1. a.
    A two-course therapy approach of preventive and prophylactic therapies is required for migraine headaches.
  2. b.
    Clinical manifestations of migraine headaches can last several hours up to several days.
  3. c.
    Migraine headaches do not affect a client’s quality of life or ability to perform activities of daily living.
  4. d.
    Migraine headaches are triggered by a calm, quiet, and dark environment.

Answer

B. Clinical manifestations of migraine headaches can last several hours up to several days.
Migraine headache symptoms can last for several hours up to several days.

12-8 §12.RQ source ↗

A nurse is monitoring increased intracranial pressure on a client. Which of the following findings would represent an abnormal intracranial pressure for an adult client in a vertical position?
  1. a.
    5 mm Hg
  2. b.
    8 mm Hg
  3. c.
    14 mm Hg
  4. d.
    20 mm Hg

Answer

D. 20 mm Hg
The normal intracranial pressure for a client in a vertical position is 7–15 mm Hg.

12-9 §12.RQ source ↗

The nurse is providing instruction to a client with newly diagnosed intracranial hypertension with increased intracranial pressure. On which of the following drugs should the nurse provide client education?
  1. a.
    Acetazolamide
  2. b.
    Lorazepam
  3. c.
    Phenytoin
  4. d.
    Lasmiditan

Answer

A. Acetazolamide
Acetazolamide is an osmotic diuretic and is used in the treatment of cerebral edema, intracranial hypertension, and to lower increased intracranial pressure.

12-10 §12.RQ source ↗

Which of the following drugs is commonly prescribed to treat seizures and can cause behavioral and psychotic adverse effects?
  1. a.
    Carbamazepine
  2. b.
    Rimegepant
  3. c.
    Acetazolamide
  4. d.
    Levetiracetam

Answer

D. Levetiracetam
Levetiracetam is used in the treatment of seizures and causes adverse effects such as behavioral symptoms of hostility and aggression as well as psychotic symptoms of hallucinations and delirium.

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Problems and answers are adapted from Pharmacology for Nurses by Tina Barbour-Taylor, Leah Mueller (Sabato), Donna Paris and Dorie Weaver, OpenStax, and are used under the CC BY-NC-SA 4.0 licence. Access for free at https://openstax.org/books/pharmacology/pages/1-introduction. Illustrations: Copyright Rice University, OpenStax, under CC BY-NC-SA 4.0 license. This adaptation is released under the same licence, is non-commercial, and is neither affiliated with nor endorsed by OpenStax or Rice University.