A young adolescent experiences infrequent migraine episodes. What ...

[Mimi]

A young adolescent experiences infrequent migraine episodes. What pharmacologic intervention is most likely to be prescribed?
 
  a. Opioid
  b. Lorazepam
  c. Ergotamine
  d. Sumatriptan

Question 2

A 10-year-old child, without a history of previous seizures, experiences a tonic-clonic seizure at school that lasts more than 5 minutes. Breathing is not impaired. Some postictal confusion occurs.
 
  What is the most appropriate initial action by the school nurse?
  a. Stay with child and have someone else call emergency medical services (EMS).
  b. Notify the parent and regular practitioner.
  c. Notify the parent that the child should go home.
  d. Stay with the child, offering calm reassurance.

[xthemafja]

Answer to Question 1

ANS: D
Sumatriptan is a serotonin agonist at specific vascular serotonin receptor sites and causes vasoconstriction in large intracranial arteries. Opioids are used infrequently because they rarely work on the mechanism of pain. Lorazepam is a benzodiazepine that acts as an anxiolytic and sedative. It is not indicated for treatment of migraine episodes. Ergotamine, an -adrenergic blocker, is used for adult vascular headaches, but it is not used in adolescents because of the side effects.

Answer to Question 2

ANS: A
Because this is the child's first seizure and it lasted more than 5 minutes, EMS should be called to transport the child, and evaluation should be performed as soon as possible. The nurse should stay with the recovering child while someone else notifies EMS.

[Mimi]

TYSM

[amcvicar]

Thanks for the timely response, appreciate it