An adult patient has been seizing continuously for 6 minutes. The provider asks the nurse to anticipate the fi…

Question

An adult patient has been seizing continuously for 6 minutes. The provider asks the nurse to anticipate the first-line pharmacologic intervention. Which medication should the nurse have ready?

Accepted Answer

Option 1: IV lorazepam 4 mg over 2 minutes; may repeat once after 5 to 10 minutes if seizing continues.

Status epilepticus = continuous seizure ≥ 5 minutes (or recurrent without return to baseline). The first-line agent is an IV benzodiazepine — lorazepam 4 mg IV (or midazolam 10 mg IM if no IV access). Phenytoin/fosphenytoin is the SECOND-line agent if seizures persist. Mannitol and epinephrine are not used for status. Airway, oxygen, side positioning, and IV access run in parallel.

Answer

Option 2: IV phenytoin 20 mg/kg loading dose infused at 50 mg/min; may repeat 10 mg/kg after 10 minutes.

Answer

Option 3: Subcutaneous epinephrine 0.3 mg into lateral thigh; may repeat after 5 to 15 minutes if needed.

Answer

Option 4: IV mannitol 1 g/kg over 20 minutes to lower intracranial pressure; may repeat 0.5 g/kg after 6 hours.

An adult patient has been seizing continuously for 6 minutes. The provider asks the nurse to anticipate the first-line pharmacologic intervention. Which medication should the nurse have ready?

In-depth explanation

Clinical scenario

Key concepts

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An adult patient has been seizing continuously for 6 minutes. The provider asks the nurse to anticipate the first-line pharmacologic intervention. Which medication should the nurse have ready?

In-depth explanation

Clinical scenario

Key concepts

Master the NCLEX-RN with MyMerci