Nokea
A client comes to the clinic for a follow-up visit. The client is prescribed lamotrigine for seizure control. The nurse suspects that the client may be experiencing Stevens-Johnson syndrome based on which of the following?
- A. Complaints of muscle pain
- B. Lesions on the mucous membranes
- C. Blisters on the face and neck
- D. Recurrence of seizure activity
- E. Dizziness
Correct Answer: A,B,C
Rationale: Stevens-Johnson syndrome (SJS) is manifested by fever, cough, muscular aches and pains, headache, and lesions of the skin, mucous membranes, and eyes; the lesions appear as red wheals or blisters, often starting on the face, in the mouth, or on the lips, neck, and extremities. Recurrence of seizure activity and dizziness are not associated with this condition.
You may also like to solve these questions
A nurse understands that lorazepam (Ativan) is the drug of choice for treating status epilepticus but that its effects last for less than 1 hour. The nurse would expect which of the following to be prescribed along with lorazepam (Ativan) during status epilepticus? Select all that apply.
- A. Ethosuximide (Zarontin)
- B. Phenytoin (Dilantin)
- C. Ethotoin (Peganone)
- D. Zonisamide (Zonegran)
Correct Answer: B
Rationale: Due to the short effects of lorazepam (Ativan), a longer-acting anticonvulsant, such as phenytoin (Dilantin), is given to continue control of seizure activity.
An older adult client is prescribed diazepam for seizure control. Which of the following would be most important for the nurse to monitor?
- A. Respiratory rate and depth
- B. Blood glucose levels
- C. Swallowing ability
- D. Speech quality
Correct Answer: A
Rationale: Apnea and cardiac arrest can occur when diazepam is administered to older adults, very ill patients, and individuals with limited pulmonary reserve. Therefore, monitoring the client's respiratory rate and depth would be most important. There is no need to monitor the client's blood glucose levels, swallowing ability, or speech quality unless these were issues before this drug therapy was initiated.
The nurse is assessing a client who is receiving felbamate. The nurse suspects that the client may be developing pancytopenia based on which assessment finding? Select all that apply.
- A. Gingival hyperplasia
- B. Sore throat
- C. Epistaxis
- D. Skin rash
- E. Bruising
Correct Answer: B,C,E
Rationale: Signs of pancytopenia include sore throat, fever, general malaise, bleeding of the mucous membranes, epistaxis (bleeding from the nose), and easy bruising. Gingival hyperplasia and skin rash are examples of adverse reactions, but these are not associated with pancytopenia.
A nurse is caring for a client who is prescribed carbamazepine. When reviewing the client's medical record, the nurse would notify the health care provider for a change in the order if the client has which of the following?
- A. Bipolar disorder
- B. Renal impairment
- C. Hearing impairment
- D. Respiratory depression
Correct Answer: B
Rationale: Carbamazepine is contraindicated among clients with renal impairment. It can be prescribed to treat bipolar disorder. The drug is not contraindicated in clients with hearing impairment or respiratory depression.
Assessment of a client receiving anticonvulsant therapy reveals the following: sore throat, chills, fever, gingival bleeding, and bruising. Which nursing diagnosis would the nurse most likely identify?
- A. Risk for Impaired Skin Integrity
- B. Impaired Oral Mucous Membranes
- C. Risk for Injury
- D. Risk for Infection
Correct Answer: D
Rationale: The assessment findings suggest pancytopenia, so Risk for Infection would be most likely. Risk for Impaired Skin Integrity would be appropriate if the client developed a rash. Impaired Oral Mucous Membranes would be appropriate if the client was exhibiting signs of gingival hyperplasia. Risk for Injury would be appropriate if the client was experiencing drowsiness, ataxia, and vision disturbances related to the drug therapy.