The nurse is caring for a client receiving intravenous antibiotic therapy for bacterial meningitis. The client has a history of seizures that are currently being controlled with phenytoin (Dilantin)

Question

The nurse institutes seizure precautions for this client because: 1. Antibiotics can decrease the effect of phenytoin (Dilantin).
2. Emotional stress increases the occurrence of seizure activity.
3. Administration of drugs intravenously can initiate seizure activity.
4. Physical stress decreases the effectiveness of antiseizure medication.

Answer 1

Antibiotics can decrease the effect of phenytoin (Dilantin).

Rationale: While both mental and physical stress cause changes in the body that increase the brain's excitability and activity, it is important to note that some antibiotics interfere with the metabolism of other drugs, including phenytoin. This is significant because it generally decreases the blood levels of phenytoin, leaving the patient more susceptible to seizure activity; this is the reason for instituting seizure precautions for this client. There is no known relationship between intravenous drug administration and seizure activity. Physical and emotional stresses are not linked to the effectiveness of anti-seizure medications or an increased incidence of seizures.