A nurse is caring for an adolescent client who is receiving carbamazepine for partial seizure disorder. Which of the following statements by the client's parent is the nurse's priority?

"He has so many new bruises on his body."

"He says his mouth is always dry."

"He says he feels sick to his stomach after taking this medication."

"He takes a 2-hour nap every day after school."

Answer and Explanation

The Correct Answer is A

A. "He has so many new bruises on his body."

This statement raises concerns about potential adverse effects of carbamazepine, such as hematologic effects like thrombocytopenia, which could manifest as bruising. Given the potential seriousness of this issue, it should be the nurse's priority to further assess and address.

B. "He says his mouth is always dry."

Dry mouth (xerostomia) is a common side effect of carbamazepine, but it is generally not as concerning as other potential adverse effects such as hematologic issues or liver toxicity.

C. "He says he feels sick to his stomach after taking this medication."

Gastrointestinal side effects, including nausea, are common with carbamazepine but are typically not as urgent or serious as other potential adverse effects.

D. "He takes a 2-hour nap every day after school."

While changes in sleep patterns can be important to monitor, especially in adolescents, it is not as urgent as addressing potential adverse effects such as bruising.

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Correct Answer is D

Explanation

A. A pretreatment electroencephalogram (EEG) is not typically required before starting valproate therapy. EEGs may be used in the diagnosis and management of seizure disorders, but they are not a standard part of valproate therapy initiation.

B. High serum sodium levels are not associated with toxic levels of valproate. Instead, valproate can cause hyperammonemia, especially in individuals with urea cycle disorders.

C. Thyroid function tests are not typically required specifically for valproate therapy. However, valproate may interfere with thyroid hormone levels, so thyroid function tests might be ordered if there are symptoms of thyroid dysfunction.

D. Monitoring liver function tests is essential when taking valproate because the medication can cause hepatotoxicity. Clients should have baseline liver function tests before starting valproate, followed by regular monitoring throughout treatment. If liver function test results indicate liver damage, the healthcare provider may adjust the dosage or discontinue the medication. Therefore, this is the correct instruction to provide to the client starting valproate therapy.

A. Avoid flossing the teeth to prevent gum irritation. B. Alcohol increases the chance of phenytoin toxicity. C. Take an antacid with the medication if indigestion occurs. D. Phenytoin turns urine blue.

Correct Answer is B

Explanation

A. Avoid flossing the teeth to prevent gum irritation: There is no evidence to suggest that flossing the teeth increases the risk of gum irritation with phenytoin use. In fact, proper dental hygiene, including flossing, is essential to prevent gum disease, which can be exacerbated by the medication.

B. Alcohol increases the chance of phenytoin toxicity: Consumption of alcohol can increase the risk of phenytoin toxicity by enhancing its effects. Therefore, clients taking phenytoin should avoid alcohol consumption to prevent adverse effects and ensure the medication's efficacy.

C. Take an antacid with the medication if indigestion occurs: Phenytoin can interact with antacids, reducing its absorption and effectiveness. Therefore, clients should not take antacids concurrently with phenytoin unless directed by their healthcare provider.

D. Phenytoin turns urine blue: Phenytoin does not typically cause changes in urine color. This statement is incorrect and not relevant to the client's medication regimen.

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A nurse is caring for an adolescent client who is receiving carbamazepine for partial seizure disorder. Which of the following statements by the client's parent is the nurse's priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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