A patient has been taking phenobarbital for 2 weeks as part of his therapy for epilepsy. He tells the nurse that he feels tense and that the least little thing bothers him now. Which is the correct explanation for this problem?
These are adverse effects that usually subside after a few weeks.
The drug must be stopped immediately because of possible adverse effects.
This drug causes deprivation of REM sleep and may cause the inability to deal with normal stress.
This drug causes the rapid eye movement (REM) sleep period to increase, resulting in nightmares and restlessness.
The Correct Answer is C
A. These are adverse effects that usually subside after a few weeks: While some adverse effects of phenobarbital may diminish over time, the symptoms described by the patient are more likely related to its impact on REM sleep.
B. The drug must be stopped immediately because of possible adverse effects: Stopping phenobarbital abruptly can lead to withdrawal symptoms and potential rebound seizures; discontinuation should be done gradually under medical supervision.
C. This drug causes deprivation of REM sleep and may cause the inability to deal with normal stress: Phenobarbital is known to disrupt REM sleep, leading to emotional lability, irritability, and difficulty coping with stress.
D. This drug causes the rapid eye movement (REM) sleep period to increase, resulting in nightmares and restlessness: Phenobarbital actually decreases REM sleep, which can lead to disturbances in sleep patterns and mood changes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D","E"]
Explanation
A. Monitor the patient's respiratory rate: It's essential to monitor the patient for any adverse effects of morphine administration, particularly respiratory depression.
B. Ensure naloxone is readily available: While naloxone is an antidote for opioid overdose, administering it would depend on the patient's response and any signs of opioid toxicity, which may not be evident at this time.
C. Report the error to the facility through the proper paperwork: Reporting the medication error is crucial for documentation, investigation, and implementation of corrective actions.
D. Inform the patient's health care provider: The healthcare provider should be notified of the medication error to ensure appropriate follow-up and monitoring of the patient.
E. Document the dose of morphine given by the MedSurg nurse: Documenting the medication administration accurately is essential for the patient's medical record and continuity of care.
Correct Answer is D
Explanation
A. "I know that I cannot switch brands of this medication." - This statement indicates an understanding of the importance of consistency in medication use. Phenytoin requires consistent dosing and should not be switched between different brands without consulting a healthcare provider.
B. "I have made an appointment to see my dentist next week." - This statement shows awareness of the need for dental care while taking phenytoin. Phenytoin can cause gum hyperplasia, so regular dental check-ups are recommended.
C. "I will notify my doctor before taking any other medications." - This statement demonstrates understanding of the potential for drug interactions with phenytoin. Phenytoin can interact with many other medications, so it's crucial to consult a doctor before starting any new medications.
D. "I'll be glad when I can stop taking this medicine." - This statement indicates a
misunderstanding about the management of epilepsy. Phenytoin is typically a long-term medication used to control seizures, and it's not usually discontinued unless directed by a healthcare provider. Further teaching is needed to address this misconception.
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