A pediatric client is on antiepileptic drug therapy. The caregiver reports the child has been lethargic, confused, and sleepy. What should the nurse do next?

• A. Contact the healthcare provider immediately.
• B. Administer a test dose to rule out overdose.
• C. Delay action until the next routine appointment.
• D. Increase the dose to improve seizure control.

Answer: (A)

Prompt evaluation for potential antiepileptic drug toxicity is essential when a child on AED therapy becomes lethargic, confused, or unusually sleepy. These signs can indicate overdose or excessive CNS depression from the medication, which in pediatrics can progress rapidly and impair breathing or consciousness. The safest next step is to contact the healthcare provider immediately so they can assess the child, review dosing and timing, and decide whether the dose needs adjustment, a medication change, or urgent evaluation. In the meantime, monitor the child closely, ensure airway and safety, and be prepared to support if symptoms worsen. Do not give a test dose, delay action, or increase the dose, as these actions could worsen toxicity and risk serious harm.