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A nurse is providing discharge instructions to a client who has epilepsy. Which of the following instructions should be included in the nurse's teaching?
(Select All that Apply.)

Refrain from climbing ladders.

Do not go swimming without a partner.

Refrain from driving unless seizure-free for 3 months.

Avoid using power tools.

Place client on the floor when having a seizure.

Place client on their back when they are recovering from a seizure.

Answer and Explanation

Correct Answer : A,B,C,D,E,F

Choice A Reason:

Refraining from climbing ladders is appropriate. Climbing ladders involves a risk of falling, which can be particularly hazardous for individuals with epilepsy. Seizures can occur unexpectedly and may cause loss of muscle control or consciousness, increasing the risk of falls from heights such as ladders. Falling from a ladder during a seizure can result in serious injuries, including head trauma, fractures, or other injuries from impact. Advising the client to refrain from climbing ladders helps mitigate the risk of falls and associated injuries during a seizure episode, promoting their safety and well-being.

Choice B Reason:

Do not go swimming without a partner is inappropriate. Swimming alone can be dangerous for individuals with epilepsy as they may be at risk of drowning if they experience a seizure while in the water. Having a swimming partner can provide assistance and ensure safety in case of a seizure.

Choice C Reason:

Refraining from driving unless seizure-free for 3 months is appropriate. Driving restrictions are often recommended for individuals with epilepsy to minimize the risk of accidents caused by seizures. Many jurisdictions require individuals with epilepsy to be seizure-free for a certain period, typically around 3 to 6 months, before resuming driving.

Choice D Reason:

Avoiding using power tools is appropriate. Operating power tools or machinery can be hazardous if a seizure occurs, potentially leading to serious injuries. Therefore, individuals with epilepsy should avoid using power tools to reduce the risk of accidents during a seizure.

Choice E Reason:

Placing client on the floor when having a seizure is appropriate. Placing the client on the floor during a seizure helps prevent injury from falls. It is safer to have the individual lie down on a flat surface to reduce the risk of head injury or other trauma during the seizure.

Choice F Reason:

Placing client on their back when they are recovering from a seizure appropriate. Placing the client on their back after a seizure helps maintain an open airway and facilitates recovery. This position allows for proper breathing and circulation while monitoring the individual's condition.

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Correct Answer is B

Explanation

Choice A Reason:

Pregabalin is incorrect. Pregabalin is a medication used to treat neuropathic pain, seizures, and generalized anxiety disorder. It is not associated with an increased risk of PML.

Choice B Reason:

Natalizumab is correct.: Natalizumab is a monoclonal antibody used to treat relapsing forms of MS. It is associated with an increased risk of developing PML, particularly in individuals who are JC virus antibody positive. Regular monitoring of JC virus antibody status and clinical vigilance is required when using natalizumab to reduce the risk of PML.

Choice C Reason:

Furosemide: Furosemide is a loop diuretic used to treat edema and hypertension. It is not associated with an increased risk of PML.

Choice D Reason:

Metoprolol is incorrect .Metoprolol is a beta-blocker used to treat hypertension, angina, and heart failure. It is not associated with an increased risk of PML.

A. Respiratory alkalosis B. Increased venous return C. Decreased cardiac output D. Dilated ventricles

Correct Answer is C

Explanation

Choice A Reason:

Respiratory alkalosis is incorrect. Tension pneumothorax typically leads to respiratory distress and hypoxemia rather than respiratory alkalosis. The respiratory alkalosis may occur initially due to hyperventilation in response to hypoxemia but would not be directly related to tracheal deviation.

Choice B Reason:

Increased venous return is incorrect. Tension pneumothorax actually leads to decreased venous return due to compression of the great vessels in the thorax, particularly the superior vena cava and the inferior vena cava. This compression results from the increased pressure within the thorax, which impedes blood flow back to the heart.

Choice C Reason:

Decreased cardiac output is incorrect. Tension pneumothorax can indeed lead to decreased cardiac output due to compression of the heart and the great vessels by the accumulating air in the pleural space. This compression decreases venous return and impairs cardiac function.

Choice D Reason:

Dilated ventricles is incorrect. As mentioned earlier, tension pneumothorax can lead to compression of the heart, including the ventricles. This compression can cause dilatation of the ventricles, particularly the right ventricle, due to increased afterload and decreased venous return.

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A nurse is providing discharge instructions to a client who has epilepsy. Which of the following instructions should be included in the nurse's teaching? (Select All that Apply.)

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A nurse is providing discharge instructions to a client who has epilepsy. Which of the following instructions should be included in the nurse's teaching?
(Select All that Apply.)