Nokea
A nurse should monitor a client closely for increased CNS depressant effects when an/ColorExtension anticonvulsant is used concomitantly with which of the following? Select all that apply.
- A. Analgesics
- B. Oral contraceptives
- C. Alcohol
- D. Antibiotics
- E. Antidiabetic medications
Correct Answer: A,C
Rationale: The concomitant use of anticonvulsants and analgesics or alcohol can result in increased CNS depressant effects.
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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.
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.
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.
The nurse would closely monitor a client taking which of the following anticonvulsants for pancytopenia? Select all that apply.
- A. Carbamazepine (Tegretol)
- B. Phenytoin (Dilantin)
- C. Valproic acid (Depakote)
- D. Felbamate (Felbatol)
- E. Zonisamide (Zonegran)
Correct Answer: A,D
Rationale: A client taking carbamazepine (Tegretol) or felbamate (Felbatol) should be monitored closely for pancytopenia.
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.