The nurse has reviewed the Provider Prescriptions on the day of discharge.
The nurse has provided information regarding the adolescent's medication for home use to the guardian and the adolescent. Select the 2 statements that demonstrate the guardian's understanding of the adolescent's medication.
"This drug won't decrease the effectiveness of their oral contraceptive medication."
"We will need to periodically have their blood drawn to check phenytoin levels."
"This medication may cause their eyes to move quickly back and forth at times."
"They will need to take 400 international units (IU) of vitamin E while on this medication."
"There is nothing we can do to minimize overgrowth of their gum tissue."
Correct Answer : B,C
A. "This drug won't decrease the effectiveness of their oral contraceptive medication.": Phenytoin induces hepatic enzymes, which increase the metabolism of oral contraceptives and reduce their effectiveness.
B. "We will need to periodically have their blood drawn to check phenytoin levels.": Phenytoin has a narrow therapeutic index, and blood levels must be monitored to avoid subtherapeutic dosing or toxic effects such as ataxia, confusion, or nystagmus.
C. "This medication may cause their eyes to move quickly back and forth at times.": Nystagmus is a known dose-related adverse effect of phenytoin, especially at higher levels. Recognizing this side effect indicates understanding of possible neurologic manifestations of toxicity.
D. "They will need to take 400 international units (IU) of vitamin E while on this medication.": Vitamin E supplementation is not required for adolescents taking phenytoin. Nutritional support may focus more on maintaining adequate folic acid and vitamin D.
E. "There is nothing we can do to minimize overgrowth of their gum tissue.": Gingival hyperplasia is a common side effect of phenytoin, but it can be minimized with proper oral hygiene such as regular toothbrushing, flossing, and dental visits.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Mild hematuria: In glomerulonephritis, hematuria is typically significant, often producing cola- or tea-colored urine. Mild hematuria alone would not reflect the degree of renal involvement usually seen with this condition.
B. Absent urine protein: Proteinuria is a common finding in glomerulonephritis due to increased permeability of the glomerular membrane. Absence of protein in the urine would not be expected.
C. Decreased blood potassium: Potassium levels usually remain normal or may increase if renal function becomes impaired. Hypokalemia is not a common laboratory finding in glomerulonephritis.
D. Hyponatremia: Children with glomerulonephritis often experience fluid retention and dilutional hyponatremia. The kidneys’ impaired ability to filter and excrete fluid contributes to low serum sodium levels.
Correct Answer is C
Explanation
A. Take the child's temperature every 10 min after administering acetaminophen: Monitoring the temperature this frequently is unnecessary and can cause anxiety for both the child and parent. Temperatures should be reassessed every few hours to evaluate medication effectiveness.
B. Wake the child every 4 hr during the night to drink 118.3 mL (4 oz) of apple juice: Rest is crucial for recovery, and children should not be routinely awakened at night for fluids unless directed by a provider. Adequate hydration should be encouraged during waking hours instead.
C. Apply a light blanket if the child begins to shiver: Shivering increases metabolic demand and body temperature. Covering the child lightly during chills helps reduce discomfort without causing overheating, making this an appropriate home care measure.
D. Place ice packs on the child's armpits and groin: Using ice packs can cause vasoconstriction and discomfort without effectively reducing fever. Safer methods include ensuring comfort with lightweight clothing, hydration, and antipyretics as prescribed.
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