A patient who is taking oral contraceptives begins taking valproic acid (Depakote) for seizures. After a week of therapy with valproic acid, the patient tells the nurse that she is experiencing nausea. What will the nurse do?
a. Ask the patient if she is taking the valproic acid with food, because taking the drug on an empty stomach can cause gastrointestinal side effects.
b. Contact the provider to request an order for a blood ammonia level, because hyperammonemia can occur with valproic acid therapy.
c. Suggest that the patient perform a home pregnancy test, because valproic acid can reduce the efficacy of oral contraceptives.
d. Suspect that hepatotoxicity has occurred, because this is a common adverse effect of valproic acid.
Question 2
A patient is to begin taking phenytoin (Dilantin) for seizures. The patient tells the nurse that she is taking oral contraceptives. What will the nurse tell the patient?
a. She may need to increase her dose of phenytoin while taking oral contraceptives.
b. She should consider a different form of birth control while taking phenytoin.
c. She should remain on oral contraceptives, because phenytoin causes birth defects.
d. She should stop taking oral contraceptives, because they reduce the effectiveness of phenytoin.
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