A nurse is caring for a female client in an outpatient clinic.

Exhibits

Click to highlight the findings that require immediate follow-up. To deselect a finding, click on the finding again.

Nurses' Notes

Day 1:

Client is seen by provider for routine follow-up after being started on axcarbazepine 150mg PO twice a day, last week. Client reports no nausea, headache, dizziness, or ataxia. Provider increased oxcarbazepine to 300 mg PO twice a day. Client is to return for a follow-up in 2 weeks.

Day 14:

Client returns for follow-up after increasing oxcarbazepine dosage. Client reports starting to have mild headaches earlier this week. Also states, "Yesterday I was very nauseated and threw up before breakfast." When talking to client they have difficulty remembering the times they are taking their axcarbazepine. Client reports using oral contraceptives as the only means of birth control.

Laboratory Results

Day 14

Hct 40% (37% to 47%)

Hgb 13g/dL (12 to 16g/dL)

Sodium 124 mEq/L (136 to 145 mEq/L)

Vitals Signs

Day 14:

Temperature 36.3°C (97.4° F)

Heart rate 86/min

mild headaches

Yesterday I was very nauseated and threw up before breakfast

difficulty remembering the times they are taking their axcarbazepine

Sodium 124 mEq/L (136 to 145 mEq/L)

Hct 40% (37% to 47%)

Answer and Explanation

The Correct Answer is ["A","B","C","D"]

Nurses' Notes Day 1:

Client is seen by provider for routine follow-up after being started on axcarbazepine 150mg PO twice a day, last week. Client reports no nausea, headache, dizziness, or ataxia. Provider increased oxcarbazepine to 300 mg PO twice a day. Client is to return for a follow-up in 2 weeks.

Day 14:

Client returns for follow-up after increasing oxcarbazepine dosage. Client reports starting to have mild headaches earlier this week. Also states, "Yesterday I was very nauseated and threw up before breakfast." When talking to client they have difficulty remembering the times they are taking their axcarbazepine. Client reports using oral contraceptives as the only means of birth control.

Laboratory Results Day 14

Hct 40% (37% to 47%)

Hgb 13g/dL (12 to 16g/dL)

Sodium 124 mEq/L (136 to 145 mEq/L) Vitals Signs

Day 14:

Temperature 36.3°C (97.4° F)

Heart rate 86/min

Rationale:

The patient's follow-up findings on Day 14, particularly the reported symptoms and laboratory results, suggest potential side effects from the increased dosage of oxcarbazepine. Common side effects of oxcarbazepine include dizziness, nausea, and vomiting. The patient's symptoms of mild headaches and nausea, along with difficulty remembering medication times, could be indicative of these side effects. Additionally, the sodium level of 124 mEq/L is below the normal range (136 to 145 mEq/L), indicating hyponatremia, which is a known side effect of oxcarbazepine and can be serious.

Hyponatremia can cause symptoms such as nausea, vomiting, exhaustion, and dizziness, aligning with the patient's reported condition. These findings warrant immediate medical attention to assess the need for adjusting the medication dosage or considering alternative treatments.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

A. Consulting a drug reference guide is the most reliable and thorough method to identify potential food and medication interactions.
B. While taking medication on an empty stomach might avoid some interactions, it is not a universally safe or effective strategy and could cause other issues.
C. Asking another nurse may provide useful information but does not guarantee comprehensive or accurate details.
D. Checking the medical record is important but may not have all the necessary information regarding new interactions specific to the medication being administered.

A. Perform blood glucose monitoring hourly. B. Monitor the client's weight weekly. C. Change the IV tubing every 24 hours. D. Change the IV dressing every 96 hours.

Correct Answer is C

Explanation

A. Hourly blood glucose monitoring is excessive; typically, blood glucose is monitored every 4-6 hours.
B. Monitoring weight weekly is not frequent enough; daily monitoring is recommended to assess fluid balance and nutritional status.
C. Changing the IV tubing every 24 hours helps prevent infection, a common complication of TPN.
D. The IV dressing should be changed more frequently, generally every 48-72 hours, or if it becomes soiled or loose, to reduce infection risk.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer a medication to a client for the first time and needs to know about potential food and medication interactions. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following actions should the nurse take to prevent adverse effects?

Correct Answer is C

Explanation

A nurse is preparing to administer filgrastim 5 mcg/kg/day subcutaneous to a client who weighs 143 lb. How many mcg should the nurse administer per day? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A nurse is teaching a client who has a new prescription for captopril. Which of the following information should the nurse include in the teaching?

A nurse is caring for a client in a provider's office. Exhibits Select the 2 statements the nurse should include in the teaching. Select the 2 statements the nurse should include in the teaching.

A nurse is providing teaching to a client who has a new prescription for rifampin. Which of the following statements should the nurse include in the teaching?

A nurse is preparing to administer heparin subcutaneously to a client. Which of the following actions should the nurse plan to take to minimize bleeding following the injection?

A nurse is caring for a client who develops an anaphylactic reaction to IV antibiotic administration. After assessing the client's respiratory status and stopping the medication infusion, which of the following actions should the nurse take next?