A nurse is caring for a client who is experiencing status epilepticus. Which of the following medications should the nurse expect to administer?
Lorazepam
Carbamazepine
Lamotrigine
Clonazepam
The Correct Answer is A
A. Lorazepam. Lorazepam is a benzodiazepine and the first-line medication for treating status epilepticus due to its rapid onset of action. It acts by enhancing the effect of GABA, an inhibitory neurotransmitter, helping to quickly stop continuous seizure activity.
B. Carbamazepine. Carbamazepine is used for long-term seizure control, particularly in partial seizures, but it is not appropriate for emergency treatment of status epilepticus due to its slower onset of action and oral route of administration.
C. Lamotrigine. Lamotrigine is also used for chronic seizure management, including generalized and partial seizures. However, it is not effective in acute seizure emergencies and is typically not administered intravenously.
D. Clonazepam. While clonazepam is a benzodiazepine used to manage seizures, it is generally used for maintenance therapy. It lacks the fast-acting IV formulation preferred in treating status epilepticus, unlike lorazepam.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Use tubing that does not have a filter in the drip chamber. Blood transfusion tubing must have a filter to trap clots, cellular debris, and other particulates, ensuring the safe administration of blood products.
B. Use an IV catheter that is at least 24-gauge. A larger bore catheter (18- to 20-gauge) is preferred for blood transfusions to reduce the risk of hemolysis and allow adequate flow. A 24-gauge is too small for standard transfusion protocols.
C. Attach a single line administration set. A Y-type tubing set is typically used, allowing for connection to both the blood product and normal saline. This setup enables flushing before and after the transfusion and provides a safe delivery system.
D. Prime the tubing with 0.9% sodium chloride. Only 0.9% sodium chloride (normal saline) should be used to prime the tubing, as it is compatible with blood products and prevents hemolysis or clot formation. Dextrose or other solutions can cause serious reactions.
Correct Answer is A
Explanation
A. Respiratory rate 10/min. This is the priority finding because it suggests respiratory depression, a serious side effect of magnesium sulfate therapy. Magnesium acts as a CNS depressant, and a respiratory rate below 12/min is a potential sign of magnesium toxicity, which can lead to respiratory arrest if not promptly addressed.
B. 2+ deep-tendon reflexes. This indicates normal neuromuscular function and is actually a reassuring finding in a client receiving magnesium sulfate. Reflexes are typically monitored to detect early signs of toxicity, and a 2+ rating means the dose is likely therapeutic.
C. 3+ pedal edema. While significant, pedal edema is a common feature of preeclampsia and not directly related to magnesium sulfate toxicity. It should be monitored but does not require immediate action compared to respiratory compromise.
D. Urinary output 35 mL/hr. This is slightly above the minimum acceptable output of 30 mL/hr, indicating the kidneys are excreting adequately. While magnesium is excreted renally and output must be monitored, this value does not indicate an acute risk.
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