The patient is receiving valproic acid (Depakene) for treatment ...

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The patient is receiving valproic acid (Depakene) for treatment of seizures. The patient has also been taking a daily 81 mg aspirin tablet prophylactically for a cardiac condition. What would the nurse be most likely to observe?
 
  1. An increase in seizure activity
  2. Stevens-Johnson syndrome
  3. Migraine headaches and generalized irritability
  4. Bleeding from the gums and bruising of the skin

Question 2

The patient tells the nurse that she has been taking phenytoin (Dilantin) for 2 years now and is still having too many side effects. She wants to stop taking it. What is the best response by the nurse?
 
  1. Please do not stop the medication abruptly, as you will have withdrawal seizures.
  2. Side effects are a problem, but they are not as bad as the seizures you were having.
  3. This is the best medication for you; we can add another medication to decrease side effects.
  4. You have probably been on the medication long enough; I'll let your doctor know you are stopping it.

[joanwhite]

Answer to Question 1

Correct Answer: 4
Rationale: Valproic acid (Depakene) can prolong bleeding time; concomitant aspirin use can cause severe bleeding. Increased seizure activity is not associated with valproic acid (Depakene) and aspirin use. Stevens-Johnson syndrome is a side effect of valproic acid (Depakene); its occurrence is not increased with concomitant aspirin use. Migraine headaches and generalized irritability do not result from valproic acid (Depakene) and aspirin use.

Answer to Question 2

Correct Answer: 1
Rationale: Seizures are likely to occur with abrupt withdrawal of antiseizure medication. The medication must be withdrawn over a period of 6 to 12 weeks. There is no other medication that can be added to decrease the side effects associated with phenytoin (Dilantin). The nurse does not know if the patient has been on the medication long enough, and the patient must be informed of the consequences of abruptly stopping the medication. Telling a patient that medication side effects are not as bad as seizures is an inappropriate and non-therapeutic response that does not address the patient's concerns.

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Excellent

[adf223]

Gracias!