A nurse is contributing to a plan of care for an 8-year-old child prescribed an anticonvulsant for pain. Which of the following recommendations should the nurse plan to make? (Select All that Apply.)

Liver enzymes should be checked before starting

Consult the prescriber for any dose adjustments.

Do not take with anti-anxiety medications.

Do not take the medication longer than a week.

An increased risk of suicide is associated with this medication.

Answer and Explanation

Correct Answer : A,B,E

A. Liver enzymes should be checked before starting. Some anticonvulsants, such as valproic acid and carbamazepine, can affect liver function. Baseline liver enzyme testing is recommended before starting therapy to monitor for potential hepatotoxicity.

B. Consult the prescriber for any dose adjustments. Anticonvulsants require careful dose titration based on the child's response, side effects, and therapeutic drug levels. The prescriber should be consulted for any necessary adjustments.

C. Do not take with anti-anxiety medications. While caution is needed when combining CNS depressants, anticonvulsants can sometimes be used alongside anti-anxiety medications if prescribed and monitored by a healthcare provider. The statement is too restrictive and does not apply universally.

D. Do not take the medication longer than a week. This is incorrect. Anticonvulsants prescribed for chronic pain management may be used for extended periods under medical supervision. Discontinuing the medication too soon can reduce effectiveness and may require a gradual taper.

E. An increased risk of suicide is associated with this medication. Certain anticonvulsants, including gabapentin, pregabalin, and carbamazepine, carry an FDA warning for an increased risk of suicidal thoughts and behaviors. Monitoring for mood changes, depression, or suicidal ideation is important.

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Correct Answer is C

Explanation

A. Suppression of pro-inflammatory cytokines. Psoriasis is driven by an increase, not suppression, of pro-inflammatory cytokines like TNF-α, IL-17, and IL-23. These cytokines trigger excessive skin cell proliferation and inflammation.

B. Increased production of sebum. Sebum production is linked to conditions like seborrheic dermatitis and acne, not psoriasis. Psoriasis is an autoimmune disorder rather than a condition caused by oil overproduction.

C. Overactivation of T-cells. Psoriasis is an immune-mediated disorder where overactive T-cells attack healthy skin cells, leading to increased inflammation and rapid skin cell turnover. This results in the formation of thick, scaly plaques seen in psoriasis.

D. Decreased number of Langerhans cells in the dermis. Langerhans cells are antigen-presenting cells involved in immune defense. While they may play a role in immune regulation, psoriasis is primarily caused by T-cell hyperactivity rather than a reduction in Langerhans cells.

A. Collect data on physical examination. B. Administer pain medication to the adolescent. C. Notify the adolescent's primary care provider. D. Collect a detailed past medical history.

Correct Answer is A

Explanation

A. Collect data on physical examination. The first priority in managing a suspected head injury is assessing the adolescent's neurological status, airway, breathing, circulation, and level of consciousness. A physical examination helps determine the severity of the injury and guides further interventions.

B. Administer pain medication to the adolescent. While pain management is important, administering medication before assessing neurological status could mask symptoms of worsening intracranial pressure, making it difficult to monitor changes in the adolescent’s condition.

C. Notify the adolescent's primary care provider. Informing the provider is necessary, but it should be done after an initial assessment to provide accurate information about the adolescent’s condition and guide appropriate interventions.

D. Collect a detailed past medical history. While medical history is valuable, it is not the immediate priority in an emergency. The primary concern is assessing the adolescent’s current condition to determine if there are signs of increased intracranial pressure or other serious complications.

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A nurse is contributing to a plan of care for an 8-year-old child prescribed an anticonvulsant for pain. Which of the following recommendations should the nurse plan to make? (Select All that Apply.)

Nursing Test Bank

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