Nokea
A nurse at a health care center has been asked to prepare a teaching plan for a client on oxazolidinedione therapy. Which of the following points should the nurse include?
- A. Avoiding exposure to ultraviolet light
- B. Taking the drug 2 hours after a meal
- C. Taking the drug with milk
- D. Avoiding carbonated drinks during therapy
Correct Answer: A
Rationale: The nurse should suggest avoiding exposure to ultraviolet light in the teaching plan of the client on oxazolidinedione therapy because of the risk for photosensitivity. The nurse need not include taking the drug 2 hours after a meal, taking the drug with milk, or avoiding carbonated drinks.
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After reviewing information about anticonvulsants, a nursing student demonstrates understanding of this group of drugs, identifying which of the following as acting to elevate the seizure threshold by decreasing postsynaptic excitation? Select all that apply.
- A. Clonazepam (Klonopin)
- B. Valproic acid (Depakote)
- C. Gabapentin (Neurontin)
- D. Lorazepam (Ativan)
- E. Trimethadione (Tridione)
Correct Answer: A,D
Rationale: Benzodiazepines (clonazepam and lorazepam) exert their effect by elevating the seizure threshold by decreasing postsynaptic excitation. Valproic acid increases the levels of GABA, gabapentin is a GABA agonist, and trimethadione decreases the repetitive synaptic transmission of nerve impulses.
The primary health care provider prescribes diazepam 10 mg IV to be administered to a client to control his seizures. The nurse would administer this drug over which time frame?
- A. 1 minute
- B. 2 minutes
- C. 5 minutes
- D. 10 minutes
Correct Answer: B
Rationale: When used to control seizures, diazepam is administered IV pushed slowly as close as possible to the IV site, allowing at least 1 minute for each 5 mg of drug. For a dosage of 10 mg, the nurse would administer the drug over 2 minutes.
When developing the teaching plan for a client receiving ethosuximide (Zarontin), the nurse would include instructions to notifypol notify the primary health care provider if which of the following occur? Select all that apply.
- A. Ataxia
- B. Blurred vision
- C. Slurred speech
- D. Joint pain
- E. Bruising
Correct Answer: B,D,E
Rationale: A nurse educating a client and family about ethosuximide (Zarontin) should tell them to notify the physician if skin rash, joint pain, unexplained fever, sore throat, unusual bleeding or bruising, drowsiness, blurred vision, or pregnancy occurs.
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.
The nurse is assessing a client for gingival hyperplasia based on the understanding that this adverse reaction is commonly associated with long-term administration of which of the following? Select all that apply.
- A. Carbamazepine (Tegretol)
- B. Phenytoin (Dilantin)
- C. Valproic acid (Depakote)
- D. Felbamate (Felbatol)
- E. Ethotoin (Peganone)
Correct Answer: B,E
Rationale: Gingival hyperplasia, although it can occur with any anticonvulsant, is commonly associated with long-term hydantoin therapy such as with phenytoin or ethotoin.