Question

A 68 year-old male patient is in the intensive care unit recovering from a hemorrhagic stroke. The patient has made some progress and is able to move his previously paralyzed left arm and leg in a limited way. His speech is also improving.

The nurse enters the room and greets the patient. The patient opens his mouth to speak, and his eyes immediately roll upward. His back arches, and then his arms and legs begin to jerk rhythmically.

Q1: What is happening to this patient?

Q2: What might have caused this event?

Q3: Which medication should be administered immediately? What medication might be prescribed for the long term?

Q4: By which route would one need to administer the medication given immediately?

Q5: Should the nurse be especially alert for any adverse effects of the medications that were administered (consider the route by which they were given)?

Q6: Are there pharmacokinetic considerations when dosing these medications? How might dosing be altered if this patient's liver function were impaired? Discuss the dosing considerations for the medication that was given for ongoing maintenance.

Q7: The nurse notes that the patient is taking several other medications, including nimodipine to control his blood pressure. Should the nurse be concerned?

Answer 1

Q1: What is happening to this patient?

He is suffering by SEIZURE(EPILEPSY) So his eyes rolls upward and his leg began to jerk.

Q2: What might have caused this event?

Brain tumor or strokes can cause epilepsy.

Q3: Which medication should be administered immediately? What medication might be prescribed for the long term?

Immediate - IV antiepileptic, Diazepam drugs is prescribed for immediate epilepsy

Long term-Phenytoin(dilantin) and it also controls partial seizures.and generalized tonic - clonic sezuires and also given by introvenously.

Q4: By which route would one need to administer the medication given immediately?

By intravenously

Q5: Should the nurse be especially alert for any adverse effects of the medications that were administered (consider the route by which they were given)?

Yes they should be alert during medications

Q6: Are there pharmacokinetic considerations when dosing these medications? How might dosing be altered if this patient's liver function were impaired? Discuss the dosing considerations for the medication that was given for ongoing maintenance.

Yes,Pharmakokinetic consideration is necessary during dosing the medication.

Dosing be reduced for patient having impaired liver function.

Liver plays a major role in the metabolism of the majority of these drugs.Liver disease can adversely affect the biotransformation of some of these drugs.

Q7: The nurse notes that the patient is taking several other medications, including nimodipine to control his blood pressure. Should the nurse be concerned?

Nurse need to concern perhaps, Antiepileptic drug levels were not affected by nimodipine treatment but circulating nimodipine concentrations were low.