A child with a febrile illness is taking a cephalosporin. While ...

[michelleunicorn]

A child with a febrile illness is taking a cephalosporin. While in the clinic for a follow-up visit, the child has a tonic-clonic seizure. The primary care NP should:
 
  a. administer acetaminophen because this is likely a febrile seizure.
  b. reassure the parent that seizures can occur while taking cephalosporins.
  c. ask the child's parent how much of the cephalosporin the child has taken.
  d. suspect the development of a secondary central nervous system infection.

Question 2

A patient who takes carbamazepine (Tegretol) for a seizure disorder is seen by a primary care NP for a routine physical examination. A complete blood count (CBC) reveals a low white blood cell (WBC) count. The NP should:
 
  a. order a WBC differential.
  b. discontinue the carbamazepine.
  c. reassure the patient that this effect is temporary.
  d. decrease the carbamazepine dose and recheck the CBC in 2 weeks.

[juiceman1987]

Answer to Question 1

C
Seizures can occur with an overdose of cephalosporins, so the NP should determine whether this has occurred. It is not correct to assume that the seizure is fever-related or that it is a normal side effect of the cephalosporin.

Answer to Question 2

A
A benign leukopenia associated with carbamazepine is common and is reversible and dose-related. A WBC differential should be performed before changing the drug regimen.

[michelleunicorn]

TYSM

[pratush dev]

Thanks for the timely response, appreciate it