Author Question: A nurse provides teaching for a patient with a newly diagnosed partial complex seizure disorder who ... (Read 108 times)

londonang · **on:** Jul 23, 2018

A nurse provides teaching for a patient with a newly diagnosed partial complex seizure disorder who is about to begin therapy with antiepileptic drugs (AEDs). Which statement by the patient indicates understanding of the teaching?

a. Even with an accurate diagnosis of my seizures, it may be difficult to find an effective drug.
b. I will soon know that the drugs are effective by being seizure free for several months.
c. Serious side effects may occur, and if they do, I should stop taking the medication.
d. When drug levels are maintained at therapeutic levels, I can expect to be seizure free.

Question 2

A patient with a form of epilepsy that may have spontaneous remission has been taking an AED for a year. The patient reports being seizure free for 6 months and asks the nurse when the drug can be discontinued.

What will the nurse tell the patient?
a. AEDs must be taken for life to maintain remission.
b. Another AED will be substituted for the current AED.
c. The provider will withdraw the drug over a 6- to 12-week period.
d. The patient should stop taking the AED now and restart the drug if seizures recur.

izzat · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: A
Even with an accurate diagnosis of seizures, many patients have to try more than one AED to find a drug that is both effective and well tolerated. Unless patients are being treated for absence seizures, which occur frequently, monitoring of the clinical outcome is not sufficient for determining effectiveness, because patients with convulsive seizures often have long seizure-free periods. Serious side effects may occur, but withdrawing a drug precipitously can induce seizures. Not all patients have seizure control with therapeutic drug levels, because not all medications work for all patients.

Answer to Question 2

ANS: C
The most important rule about withdrawing AEDs is that they should be withdrawn slowly over 6 weeks to several months to reduce the risk of status epilepticus (SE). AEDs need not be taken for life if seizures no longer occur. Substituting one AED for another to withdraw AED therapy is not recommended. Stopping an AED abruptly increases the risk of SE.