A client is prescribed celecoxib for joint pain. What statement by the client indicates a need for further teaching?

Choice A reason: Stopping AEDs when seizures stop is incorrect, as it risks rebound seizures due to unopposed neuronal excitability. Most patients require long-term therapy to maintain seizure control, especially in chronic epilepsy, guided by neurological evaluation.
Choice B reason: AED therapy is often lifelong for chronic epilepsy, as seizures result from persistent neuronal hyperexcitability. Maintaining therapeutic drug levels prevents recurrence, as the underlying neurological predisposition remains, requiring continuous management to stabilize brain activity.
Choice C reason: Consistent dosing maintains steady-state AED levels, preventing subtherapeutic concentrations that could trigger seizures. Fluctuations in drug levels disrupt neuronal stabilization, increasing seizure risk, making adherence to dosing schedules critical for effective epilepsy control.
Choice D reason: Skipping doses due to adverse effects is dangerous, as it lowers AED levels, increasing seizure risk. Adverse effects should be managed by consulting the provider to adjust doses or switch medications, not by skipping doses.
Choice E reason: Abruptly discontinuing AEDs can cause rebound seizures due to sudden loss of neuronal stabilization, leading to excitotoxicity. Gradual tapering under medical supervision is required to minimize withdrawal-induced seizures, making this a critical teaching point.

Choice A reason: A supine or prone position may allow milk or secretions to pool, but this is not the primary reason for otitis media susceptibility. Positioning contributes indirectly by facilitating fluid reflux, but anatomical factors are more significant in infants.
Choice B reason: Sucking on a nipple does not significantly create middle ear pressure. While bottle-feeding in a supine position may allow fluid reflux into the eustachian tube, this is secondary to the anatomical structure of the tube itself.
Choice C reason: Infants are prone to upper respiratory infections due to immature immunity, which can lead to otitis media. However, this is a contributing factor, not the primary anatomical reason, as infections exploit the eustachian tube’s structure to cause middle ear inflammation.
Choice D reason: Infants’ eustachian tubes are shorter, straighter, and wider than in adults, allowing easier passage of bacteria from the nasopharynx to the middle ear. This anatomical feature impairs drainage and ventilation, increasing susceptibility to fluid accumulation and infection, making it the primary cause.