A nurse is caring for a client who has bipolar disorder and is prescribed carbamazepine (Tegretol). Which of the following instructions should the nurse include in the teaching?
“Avoid grapefruit juice while taking this medication.”
“Take this medication with food.”
“Report any signs of jaundice immediately.”
“Expect to see therapeutic effects within 1 week.”
“Use a reliable form of birth control while taking this medication.”
The Correct Answer is A
Grapefruit juice can interact with carbamazepine and increase its blood levels, which can lead to toxicity and adverse effects such as drowsiness, dizziness, blurred vision, nausea, vomiting, and rash. Therefore, the client should avoid grapefruit juice while taking this medication.
Choice B is wrong because taking carbamazepine with food does not affect its absorption or metabolism.
Choice C is wrong because jaundice is not a common side effect of carbamazepine. However, carbamazepine can cause liver toxicity, so the client should report any signs of nausea, vomiting, abdominal pain, or dark urine.
Choice D is wrong because carbamazepine may take several weeks to reach its full therapeutic effect for bipolar disorder. The client should not expect to see immediate improvement in mood symptoms.
Choice E is wrong because carbamazepine does not affect the efficacy of hormonal contraceptives. However, some other anticonvulsants, such as phenytoin and phenobarbital, can reduce the effectiveness of birth control pills and increase the risk of pregnancy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Lithium carbonate can cause a range of side effects, including increased urination, mild thirst, and electrolyte imbalances. These effects can lead to hyponatremia, which is a low level of sodium in the blood.Hyponatremia can cause symptoms such as confusion, weakness, and muscle cramps.
Choice A is wrong because lithium carbonate does not cause hypertension (high blood pressure).In fact, it may lower blood pressure by reducing the activity of the renin-angiotensin system.
Choice B is wrong because lithium carbonate does not cause hypotension (low blood pressure) by itself.However, it may enhance the effects of other drugs that lower blood pressure, such as diuretics or antihypertensives.
Choice C is wrong because lithium carbonate does not cause hypernatremia (high level of sodium in the blood).On the contrary, it can cause sodium loss through increased urination and thirst.Hypernatremia can cause symptoms such as dehydration, irritability, and seizures.
Correct Answer is C
Explanation
This is because lithium carbonate can cause fluid and electrolyte imbalance, especially when the client has vomiting and diarrhea.Drinking fluids can help maintain hydration and prevent lithium toxicity, which can cause tremors, confusion, nausea, and muscle weakness.
Choice A is wrong because stopping the medication abruptly can cause withdrawal symptoms and relapse of bipolar disorder.The client should continue taking the medication as prescribed and report any adverse effects to the provider.
Choice B is wrong because taking an extra dose of the medication can increase the risk of lithium toxicity, which can be life-threatening.The client should not adjust the dosage without consulting the provider.
Choice D is wrong because taking an antacid can alter the absorption of lithium carbonate and affect its blood levels.The client should avoid taking any other medications without consulting the provider.
Normal ranges for lithium carbonate are 0.6 to 1.2 mEq/L for maintenance therapy and 1.0 to 1.5 mEq/L for acute mania.The client should have regular blood tests to monitor the lithium levels and adjust the dosage accordingly.
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