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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["25"]
Explanation
Calculate the total drops needed:
Total drops (gtt) = Total volume (mL) x Drop factor (gtt/mL)
=100 mL x 15 gtt/mL
= 1500 gtt
Calculate the infusion time in minutes:
1 hour x 60 minutes/hour = 60 minutes
Calculate the drops per minute (gtt/min)
Total drops per min (gtt/min) = Total drops (gtt) / Total minutes (min)
=1500 gtt / 60 min
= 25 gtt/min
The nurse should set the manual IV infusion to deliver 25 gtt/min.
Correct Answer is ["C","E"]
Explanation
A. Atrial fibrillation on the cardiac monitor. Rheumatic fever can cause carditis, but atrial fibrillation is not a typical finding. Instead, valvular damage, tachycardia, or murmurs are more commonly observed.
B. Elevated BUN and creatinine on morning laboratory results. Rheumatic fever primarily affects the heart, joints, skin, and brain, not the kidneys. Elevated BUN and creatinine are more indicative of post-streptococcal glomerulonephritis, a separate complication of streptococcal infection.
C. Involuntary movements of extremities. Sydenham’s chorea, characterized by involuntary, jerky movements, is a classic neurologic manifestation of rheumatic fever. It results from inflammation affecting the basal ganglia of the brain.
D. Alopecia. Rheumatic fever does not cause alopecia. Hair loss is more commonly associated with autoimmune diseases such as lupus, not post-streptococcal complications.
E. Report of chest pain. Chest pain can indicate carditis, a major criterion for rheumatic fever. Inflammation of the heart's endocardium, myocardium, or pericardium may lead to pain, murmurs, or heart failure symptoms.
F. Oliguria. Decreased urine output is more commonly seen in post-streptococcal glomerulonephritis rather than rheumatic fever, as rheumatic fever primarily affects the heart, joints, and nervous system.
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