Nokea
A client is prescribed phenytoin daily for seizures. The nurse teaches the client about the importance of adhering to the dosage schedule based on the understanding that which of the following may occur if a single dose is missed?
- A. CNS depression
- B. Hypotension
- C. Recurrence of seizures
- D. Nystagmus
Correct Answer: C
Rationale: Recurrence of seizure activity may result from abrupt discontinuation of the drug, even when the anticonvulsant is being administered in small daily doses. Abrupt discontinuation of the drug does not cause CNS depression, hypotension, or nystagmus. CNS depression, hypotension, and nystagmus are adverse reactions of phenytoin.
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A nurse is developing a plan of care for a client receiving anticonvulsant therapy and identifies a nursing diagnosis of Risk for Injury. Which assessment findings would support this nursing diagnosis? Select all that apply.
- A. Epistaxis
- B. Reports of blurred vision
- C. Complaints of dizziness
- D. Photosensitivity
- E. Scaling red rash
Correct Answer: B,C,D
Rationale: A client would be at risk for injury if the client was experiencing blurred vision, dizziness, and photosensitivity. Epistaxis would support a nursing diagnosis of a possible Risk for Injury related to a reduction in platelets from hematologic adverse reactions. A scaling red rash would support a nursing diagnosis of Impaired Skin Integrity.
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 suspects that the client is developing toxicity if assessment reveals which of the following?
- A. Constipation
- B. Slurred speech
- C. Diarrhea
- D. Urinary frequency
Correct Answer: B
Rationale: The nurse should monitor the client for slurred speech, which is a sign of toxicity. Constipation, diarrhea, and urinary frequency are not signs of ethotoin toxicity.
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.
A nurse is assessing a client's seizure activity. Which of the following would the nurse include? Select all that apply.
- A. Description of seizures
- B. Seizure frequency
- C. Average length of seizures
- D. Description of aura
- E. Description of the degree of impairment
Correct Answer: A,B,C,D,E
Rationale: The nurse's general assessment of seizure activity should include the following: description of seizures, seizure frequency, average length of seizures, description of aura, description of the degree of impairment, and description of what appears to bring on the seizure.