Assignment task:
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. Want Professional Help?
Q7: The nurse notes that the patient is taking several other medications, including nimodipine to control his blood pressure. Should the nurse be concerned? (Take a look in Epocrates or on Medscape or in Davis's Drug Guide and check for interactions- consider what anti-epilepsy drugs do to the CYP450 enzymes long-term) Consider interactions with the medication that was given for ongoing maintenance.