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25 Cards in this Set

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How does Phenytoin [Dilantin] work and what is it used for?
It is an antiepileptic that reduces voltage frequency and spread of electrical discharges. General mechanism is that it stabilizes neuronal membranes and limits the spread of seizure activity by affecting the motor cortex.

Used for management of tonic-clonic seizures, can be used for status epilepticus.
How does Carbamazepine [Tegretol] work and what is it used for?
It is an antiepileptic that reduces synaptic reaction. General mechanism is that it stabilizes neuronal membranes and limits the spread of seizure activity by affecting the motor cortex.

Used for management of tonic-clonic seizures, can be used for status epilepticus.
How does Valproic Acid [Depakene] and what is it used for?
An antiepileptic that blocks sodium and calcium channels to prevent neuron firing. General mechanism is that it stabilizes neuronal membranes and limits the spread of seizure activity by affecting the motor cortex.

Used for management of tonic-clonic seizures, can be used for status epilepticus.
What are major side effects of antiepileptic drugs?
Gingival hyperplasia.
What are the important patient teaching for patients that are taking antiepileptic drugs?
-Teach client to purchase a Medic-Alert bracelet or carry a medical ID card.
-Teach client to never abruptly discontinue medication.
-With Dilantin, watch for gingival hyperplasia; encourage routine prophylactic dental care, and instruct client to take with meals.
What is the important nursing implication for patients on antiepileptics?
Perform periodic blood studies for therapeutic levels.
What is the use and mechanism of action of Hydroxyzine [Vistaril]?
-Preoperative and postoperative sedation, antiemetic
-Works by producing an anticholinergic, antihistaminic, analgesic effects; relaxes skeletal muscle; helps control n/v
-It will make the patient feel relaxed and then sleepy.
What is the use and mechanism of aciton of Lorazepam [Ativan]?
-Preoperative sedation, seizures and anxiety

-Works by producing muscle relaxation, has anticonvulsant, sedative, antiemetic effects, decreases anxiety.
-It will make the patient feel calmer and then become more sedated.
What is important to watch for when administering Hydroxyzine [Vistaril]??
Watch for drowsiness, dry mouth, dizziness, ataxia, and pain with IM injection (use z-track when giving IM)
What is important to watch for when administering Lorazepam [Ativan]?
Watch for retrograde amnesia, unsteadiness, drowsiness, and abdominal discomfort.
What are important nursing implications when adminstering Hydroxyzine (Vistaril) and Lorazepam (Ativan)?
-Assess motor response, monitor vital signs and fluids and electrolytes, monitor bowel and bladder activity
-Adminster intravenous (IV) medications slowly to avoid life-treatening reactions (Severe hypotension, respiratory and cardiac arrest).
What is important to teach the client when adminstering Hydroxyzine (Vistaril) and Lorazepam (Ativan)?
-Teach client that oral preparations of Ativan should be taken with meals
-Teach client to never abruptly discontinue oral medications.
What type of medication is Prochlorperazine (Compazine)?
Antiemetic. It blocks dopamine receptors involved in activating the vomiting reflex.
What is the rhyme that helps to identify the use of Prochlorperazine (Compazine)?
When you are in a rut and can't stop hugging the bowl, its time for compazine, an antiemetic for severe nausea and vomiting.
What What are important side effects to watch for when a patient is taking Prochlorperazine (Compazine)?
-Drowsiness, dizziness, hypotension, dry mouth, akathisia, dystonia, tardive dyskinesia and other extrapyramidal reactions

-An antiemetic can mask the toxicity symptoms of other drugs on board.
What patients may receive Prochlorperazine (Compazine)?
-Patients experiencing N/V that are associated with surgery, chemotherapy and varied noxious stimuli.
What are important nursing implications when administering Prochlorperazine (Compazine)?
-Assess the cause for n/v
-Observe for hypersensitivity reactions
What is important patient teaching for a patient taking Prochlorperazine (Compazine)?
-Instruct client about orthostatic hypotension
-Instruct client to avoid hazardous or activities requiring mental alertness.
What is the use of Promethazine (Phenergan) and how does it work?
Used for motion sickness, vertigo, and perioperative N/V.

-Blocks histamine receptors in the neuronal pathway, leading from the vestibular apparatus of the inner ear to the vomiting center in the medulla.
What are important side effects to be aware of when administering Promethazine (Phenergan)?
-Drowsiness, restlessness, hypotension, confusion, urinary retention (most frequent).
What are important teaching factors to include when administering Promethazine (Phenergan)?
-Teach client to avoid tasks that require mental alertness.
-Direct client to report tremors or abnormal body movement
-Long term therapy--Teach client to have CBC drawn.
What is the use of Midazolam (Versed)?
It is a benzodiazepine, that produces unconsciousness and amnesia. It is used for induction of anesthesia and conscious sedation (pt will be able to hear and respond to simple comands).

"Moments not remembered"
What are important side effects to be aware of when Midazolam (Versed) is being administered?
-Respiratory Depression, dysrhythmias, hypotension, unresponsiveness, agitation, confusion.
When should one be cautious of allowing a patient to be given Midazolam (Versed)?
-Can cause dangerous cardiorespiratory effects, including respiratory depression and cardiac arrests.
What are important nursing implications when administering Midazolam (Versed) to a patient??
-Administer slowly over 2 or more minutes. Wait another 2 or more minutes for full effects to develop before giving additional doses to avoid cardiorespiratory problems.
-Unconsciousness develops quickly (w/in 60-80 seconds). Conscious sedation persists for approx. 1 hour.
-Perform constant cardiac and respiratory monitoring during administration with resuscitative equipment nearby.