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 A
Explanation
A. "I'll be glad when I can stop taking this medicine.": This statement indicates a misunderstanding about phenytoin therapy. Phenytoin is typically a long-term medication used to prevent seizures, and it is not typically discontinued unless under the guidance of a healthcare provider. The nurse should clarify that stopping the medication abruptly can lead to rebound seizures and should emphasize the importance of continuing the medication as prescribed.
B. "I have made an appointment to see my dentist next week.": This statement indicates appropriate understanding, as regular dental check-ups are important for individuals taking phenytoin due to the medication's potential side effect of gingival hyperplasia.
C. "I know that I cannot switch brands of this medication.": This statement demonstrates understanding, as different brands of phenytoin can have variations in bioavailability, which can affect seizure control. It is important for clients to remain consistent with the same brand or formulation unless directed otherwise by their healthcare provider.
D. "I will notify my doctor before taking any other medications.": This statement indicates understanding of the potential for drug interactions with phenytoin, as it is a hepatic enzyme inducer and can affect the metabolism of other medications. Clients should always consult their healthcare provider before taking any new medications or supplements to ensure compatibility with phenytoin therapy.
Correct Answer is ["C","D","E"]
Explanation
Answer:C, D, E
Rationale:
A) Rotate staff that administer the medications: Rotating staff can lead to inconsistency in communication and rapport with the client. A consistent nursing team is more likely to build trust and encourage adherence to medication therapy. Therefore, this intervention may not effectively promote adherence.
B) Engage the client in conversation following medication administration: While engaging the client in conversation can help build rapport and create a supportive environment, it may not be the most effective intervention for encouraging medication adherence. The priority should be focused on ensuring the client takes the medication as prescribed, rather than focusing on conversation after administration.
C) Use sustained-release forms: Sustained-release formulations can help with adherence by providing a more consistent therapeutic effect and reducing the number of doses a client needs to take throughout the day. This can simplify the medication regimen, making it easier for the client to adhere.
D) Provide for once-daily dosing: Once-daily dosing is beneficial for improving adherence because it reduces the complexity of the medication regimen. Clients are more likely to remember to take their medication if they only need to do so once a day.
E) Perform mouth checks following the administration of the medication: Performing mouth checks can help ensure that the client has actually taken the medication, especially if there is suspicion of non-adherence. This intervention can confirm that the medication is ingested and can serve as a prompt for adherence in future doses.
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