Nokea
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.
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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 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.
A primary health care provider prescribes phenytoin to be administered parenterally to a client with a seizure disorder. The nurse prepares the drug to be given by which method?
- A. Intradermally
- B. Subcutaneously
- C. Intramuscularly
- D. Intravenously
Correct Answer: D
Rationale: Phenytoin can be administered orally and parenterally. If the drug is administered parenterally, the intravenous (IV) route is preferred over the intramuscular (IM) route, because with the IM route erratic absorption of phenytoin causes pain and muscle damage at the injection site. The drug is not administered intradermally or subcutaneously.
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.
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.