The client has epilepsy and is prescribed phenytoin (Dilantin). ...

[vicky]

The client has epilepsy and is prescribed phenytoin (Dilantin). The client has been seizure free and asks the nurse why he still needs blood tests when he is not having seizures. Which response by the nurse is the most appropriate?
 
  1. Dilantin can cause blood thinning in some people.
  2. There is a narrow range between a helpful dose of this medication and a dose that could make you feel sicker.
  3. Dilantin tends to lower blood levels of potassium.
  4. This medication can cause a severe skin reaction called StevenJohnson syndrome if doses are too high.

Question 2

The nurse is speaking before a group of elementary school teachers on the topic of seizure control medications. Which behaviors should the nurse advise the teachers to watch for in children who are taking levetiracetam (Keppra)?
 
  Standard Text: Select all that apply.
  1. Sleepiness after lunch
  2. Fighting at recess
  3. Inability to sit still
  4. Tearfulness
  5. Difficulty in seeing the blackboard

[ApricotDream]

Answer to Question 1

Correct Answer: 2
Rationale 1: Phenytoin (Dilantin) is not an anticoagulant and does not cause thinning of the blood.
Rationale 2: Phenytoin (Dilantin) has a very narrow range between a therapeutic dose and a toxic dose; blood levels must be monitored to ensure a therapeutic level and to prevent toxicity.
Rationale 3: There is no evidence that phenytoin (Dilantin) causes potassium depletion.
Rationale 4: StevensJohnson syndrome is a severe skin reaction that can be an adverse outcome with phenytoin (Dilantin), but it is monitored by skin assessment, not blood tests.
Global Rationale: Phenytoin (Dilantin) has a very narrow range between a therapeutic dose and a toxic dose; blood levels must be monitored to ensure a therapeutic level and to prevent toxicity. It is not an anticoagulant and does not cause thinning of the blood. There is no evidence that phenytoin (Dilantin) causes potassium depletion. StevensJohnson syndrome is a severe skin reaction that can be an adverse outcome with phenytoin (Dilantin), but it is monitored by skin assessment, not blood tests.

Answer to Question 2

Correct Answer: 2,3,4
Rationale 1: Levetiracetam (Keppra) would be more likely to cause children to be agitated.
Rationale 2: Levetiracetam (Keppra) can cause hostility in some children and may manifest as inability to get along with others.
Rationale 3: Hyperkinesis is a common side effect of levetiracetam (Keppra).
Rationale 4: Depression is a common side effect of levetiracetam (Keppra).
Rationale 5: There is no indication that difficulty seeing the blackboard is associated with levetiractam (Keppra).
Global Rationale: Levetiracetam (Keppra) can cause hostility in some children and may manifest as inability to get along with others. Hyperkinesis and depression are also common side effects of levetiracetam (Keppra). Levetiracetam (Keppra) would be more likely to cause children to be agitated rather than sleepy. There is no indication that difficulty seeing the blackboard is associated with levetiractam (Keppra).

[vicky]

Thanks for the timely response, appreciate it

[bitingbit]

Gracias!