Which data should the nurse assess for the client with a seizure disorder who is taking valproate (Depakote)?

Creatinine and BUN.

White blood cell count.

Red blood cell count.

Liver enzymes.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Creatinine (normal range: 0.6-1.2 mg/dL) and Blood Urea Nitrogen (BUN) (normal range: 7-20 mg/dL) are indicators of kidney function. While kidney function is important, valproate is primarily metabolized by the liver, making liver function monitoring more critical than routine renal function assessment for this medication.

Choice B rationale

White blood cell count (normal range: 4,000-11,000 cells/µL) measures components of the immune system. Although some anticonvulsants can affect blood counts, valproate's primary adverse effect profile does not typically involve significant or common alterations in white blood cell count requiring routine monitoring.

Choice C rationale

Red blood cell count (normal range: 4.2-5.4 million cells/µL for women; 4.7-6.1 million cells/µL for men) measures oxygen-carrying capacity. While certain medications can cause anemia, valproate is not commonly associated with significant hematological toxicities involving red blood cells that necessitate routine monitoring.

Choice D rationale

Liver enzymes, such as ALT (normal range: 7-56 U/L) and AST (normal range: 10-40 U/L), are crucial to assess for a client taking valproate. This medication is hepatically metabolized and can cause dose-related transient elevations or, rarely, severe, potentially fatal hepatotoxicity, necessitating regular monitoring of liver function.

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Correct Answer is B

Explanation

Choice A rationale

Atenolol is a beta-blocker primarily used to treat hypertension, angina, and certain arrhythmias. It acts by blocking beta-adrenergic receptors, reducing heart rate and blood pressure. It is not indicated for the acute management of status epilepticus, which requires rapid cessation of seizure activity.

Choice B rationale

Lorazepam is a benzodiazepine that enhances the effect of the inhibitory neurotransmitter GABA in the brain. This leads to generalized central nervous system depression, effectively terminating ongoing seizure activity. Its rapid onset of action makes it a first-line medication for status epilepticus.

Choice C rationale

Phenytoin is an anticonvulsant commonly used for long-term seizure control. While it can be used to prevent recurrence of seizures after initial control of status epilepticus, its onset of action is slower compared to benzodiazepines, making it less suitable for immediate termination of ongoing status epilepticus.

Choice D rationale

Lisinopril is an ACE inhibitor used to treat hypertension and heart failure. It works by inhibiting the conversion of angiotensin I to angiotensin II, leading to vasodilation and reduced blood pressure. It has no direct antiepileptic properties and is not indicated for the management of status epilepticus.

A. I became short of breath an hour before coming to the hospital. B. I have been taking acetaminophen every 6 hours for chest wall pain. C. I have been using my albuterol inhaler frequently over the last 4 days. D. I have not had any acute asthma attacks during the past year.

Correct Answer is C

Explanation

Choice A rationale

This statement describes the onset of the patient's current symptoms, which is important information for assessment but does not indicate a knowledge deficit about medication use. It simply provides context for the acute asthma exacerbation they are experiencing, assisting in understanding the disease progression.

Choice B rationale

Taking acetaminophen for chest wall pain is a symptomatic treatment and does not necessarily indicate a lack of understanding about asthma medications. Chest wall pain can be a secondary symptom of asthma exacerbation due to increased respiratory effort, and acetaminophen is a common analgesic for such discomfort.

Choice C rationale

Frequent use of a rescue inhaler, such as albuterol, over several days indicates inadequate control of asthma and a potential over-reliance on a short-acting bronchodilator. This suggests a need for teaching about proper medication use, including the role of maintenance medications and when to seek medical attention for worsening symptoms.

Choice D rationale

This statement indicates good asthma control over the past year, which is a positive outcome. It does not suggest a need for medication teaching; rather, it implies adherence to a successful management plan or a period of disease remission. This patient's statement is reassuring, not concerning.

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Which data should the nurse assess for the client with a seizure disorder who is taking valproate (Depakote)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient that is experiencing status epilepticus. Which of the following prescribed medications should the nurse anticipate to administer?

Correct Answer is B

Explanation

A nurse admits a patient who has a diagnosis of acute asthma. Which statement indicates that the patient may need teaching regarding medication use?

Correct Answer is C

Explanation

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