Author Question: A nurse caring for a patient with a history of seizures observes a sudden muscle contraction in the ... (Read 93 times)

roselinechinyere27m · **on:** Jul 23, 2018

A nurse caring for a patient with a history of seizures observes a sudden muscle contraction in the right arm that lasts approximately 1 second.

The nurse recognizes this finding as a myoclonic seizure and anticipates that the prescriber will order which medication?
a. Phenytoin (Dilantin)
b. Lorazepam (Ativan)
c. Ethosuximide (Zarontin)
d. Valproic acid (Depakote)

Question 2

A patient has been on carbamazepine (Tegretol) therapy for 3 weeks and comes to the clinic for a follow-up appointment.

The patient complains of fatigue, headache, and vertigo. After laboratory tests are completed, which laboratory value would cause the most concern?
a. Hemoglobin: 12 g/dL
b. Leukocytes: 8,000 mm3
c. Platelets: 280,000 mm3
d. Carbamazepine (Tegretol): 10 mcg/mL

juliaf · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: D
The patient displays symptoms of a myoclonic seizure, which is characterized by a sudden muscle contraction lasting approximately 1 second or that may involve the whole body. The drug of choice for myoclonic seizures is valproic acid.
Phenytoin (Dilantin) is the drug of choice for grand mal seizures.
Lorazepam (Ativan) is the drug of choice for status epileptics.
Ethosuximide (Zarontin) is a drug often used in the treatment of petit mal seizures.

Answer to Question 2

ANS: A
The hematologic effects of carbamazepine can cause leukopenia, anemia, and thrombocytopenia. With the patient's complaints of fatigue, the nurse should focus on the hemoglobin levels, which are low (14 to 18 g/dL) and may indicate anemia.
The leukocytes values are within normal limits (5,000 to 10,000mm3).
The platelets levels are within normal limits (150,000 to 350,000 mm3).
A normal carbamazepine level is 10 to 20 mcg/mL.