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."
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
D. Wernicke-Korsakoff psychosis is a neurological disorder caused by thiamine (vitamin B1) deficiency, often resulting from chronic alcohol use disorder. Thiamine deficiency can lead to significant neurological impairments, including confusion, ataxia, and memory deficits characteristic of Wernicke's encephalopathy and Korsakoff's psychosis.
The primary intervention for Wernicke-Korsakoff psychosis is the administration of thiamine supplementation. Thiamine replacement therapy is essential to prevent further neurological deterioration and to potentially reverse some of the cognitive deficits associated with the disorder.
The other options are not directly related to Wernicke-Korsakoff psychosis:
A. Monitoring for the presence of esophageal varices is more relevant to complications of chronic liver disease, such as cirrhosis, commonly seen in individuals with alcohol use disorder, but not specific to Wernicke-Korsakoff psychosis.
B. Placing the client in protective isolation is not indicated for Wernicke-Korsakoff psychosis. Protective isolation is typically used for clients with compromised immune systems to reduce the risk of infection.
C. Laboratory analysis of cardiac enzymes is typically performed to assess for myocardial injury or infarction, which is not directly associated with Wernicke-Korsakoff psychosis.
Correct Answer is ["20"]
Explanation
To calculate the dose of midazolam to administer, we need to convert the client's weight from pounds to kilograms, and then multiply by the dose per kilogram.
Given: Client weight = 220 lb
Dose of midazolam = 0.2 mg/kg
First, let's convert the client's weight from pounds to kilograms:
1 lb ≈ 0.453592 kg (approximately 0.45 kg, for simplicity)
Client weight in kilograms ≈ 220 lb × 0.45 kg/lb ≈ 99 kg
Now, let's calculate the dose of midazolam:
Dose = Weight (in kg) × Dose per kg Dose ≈ 99 kg × 0.2 mg/kg = 19.8 mg
Rounded to the nearest whole number, the nurse should administer approximately 20 mg of midazolam.
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