In which client would a prescription of valproic acid for seizure disorder be contraindicated?

A patient with hypertension

A patient with diabetes

A patient with asthma

A pregnant patient

Answer and Explanation

The Correct Answer is D

A. A patient with hypertension:
Valproic acid is not contraindicated in patients with hypertension. While it is important to monitor for potential side effects, including those that may affect the liver or blood pressure, hypertension alone does not directly impact the safety or efficacy of valproic acid. Therefore, it is generally considered safe to prescribe in patients with well-controlled hypertension.

B. A patient with diabetes:
Valproic acid is also not contraindicated in patients with diabetes. While it is important to monitor blood glucose levels, as anticonvulsants can sometimes affect metabolic processes, there is no absolute contraindication for valproic acid in diabetic patients. However, appropriate monitoring of blood sugar levels would be necessary to adjust any diabetic treatment as needed.

C. A patient with asthma:
There is no direct contraindication to using valproic acid in a patient with asthma. While asthma medications and their interactions should always be considered, valproic acid does not typically exacerbate asthma symptoms. The prescription would be based on the clinical need for seizure management and monitored for any potential respiratory side effects.

D. A pregnant patient:
Valproic acid is contraindicated in pregnancy due to its high risk of causing fetal harm. It has been associated with an increased risk of birth defects, including neural tube defects, and other complications such as developmental delays. The U.S. FDA classifies valproic acid as a Category D drug for pregnancy, indicating that it should only be used when the potential benefits outweigh the risks. Thus, it should be avoided in pregnant patients unless no safer alternatives are available.

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Free Nursing Study Resources

Correct Answer is A

Explanation

The client is showing signs of fluid overload due to heart failure exacerbation, including:

Progressive shortness of breath (fluid in the lungs)
Jugular venous distention (JVD) (increased central venous pressure)
Crackles in the lung bases (pulmonary congestion/edema)
Bounding pulse (increased circulating volume)

IV diuretics (e.g., Furosemide/Lasix) are the first-line treatment to rapidly reduce fluid overload by promoting diuresis and decreasing pulmonary congestion.

A. HD cholesterol 60 mg/di B. Total cholesterol 210 mg/at C. LDL cholesterol 110 me di D. Hgb A1C 5.3%

Correct Answer is C

Explanation

A) "HDL cholesterol 60 mg/dL":
This is not a risk factor. High-density lipoprotein (HDL) is often referred to as "good cholesterol" because it helps remove excess cholesterol from the bloodstream, lowering the risk of atherosclerosis and cardiovascular disease. An HDL level of 60 mg/dL is considered protective against cardiovascular disease, as higher levels of HDL are associated with a lower risk of heart disease.

B) "Total cholesterol 210 mg/dL":
This is not a significant risk factor on its own. While total cholesterol above 200 mg/dL is a general indicator for cardiovascular risk, it is not as important as the breakdown of individual lipid components (HDL, LDL). A total cholesterol of 210 mg/dL is only slightly above the ideal less than 200 mg/dL, and on its own, it is not a strong indicator of increased cardiovascular risk without considering other factors like LDL and HDL levels.

C) "LDL cholesterol 110 mg/dL":
. Low-density lipoprotein (LDL) is known as "bad cholesterol" because it can lead to the buildup of plaque in the arteries, increasing the risk for atherosclerosis, heart disease, and stroke. An LDL level of 110 mg/dL is considered to be above optimal. For individuals at risk for cardiovascular disease, the target LDL cholesterol level is usually less than 100 mg/dL, and for those with high risk, it may be less than 70 mg/dL. Therefore, this level of LDL cholesterol places the client at increased risk for cardiovascular disease.

D) "Hgb A1C 5.3%":
This is not a risk factor. An Hgb A1C of 5.3% is within the normal range for glycemic control. The American Diabetes Association defines normal A1C as below 5.7%. A1C levels between 5.7% and 6.4% are considered pre-diabetes, and a level of 6.5% or higher indicates diabetes. A normal A1C level indicates no significant elevated blood glucose, which would be a risk factor for cardiovascular disease.

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In which client would a prescription of valproic acid for seizure disorder be contraindicated?

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