The client who is prescribed valproic acid (Depakote) for seizure ...

[NguyenJ]

The client who is prescribed valproic acid (Depakote) for seizure control would like to have a baby. Which statements should the nurse include in a discussion with this client?
 
  Standard Text: Select all that apply.
  1. Since your epilepsy may flare up during pregnancy, your doctor will likely have you take a second antiepileptic medication.
  2. Thankfully, most modern antiepileptic medications will not interfere with your getting pregnant.
  3. Your current antiepileptic medication should not be used when you are pregnant.
  4. Folic acid supplementation is important for you.
  5. You should consider adopting a baby instead since there are so many problems associated with epilepsy and pregnancy.

Question 2

An emergency department (ED) client's wife says, I couldn't wake my husband up this morning. He was snoring so loudly. Why, he was so asleep he urinated in the bed. He has never done anything like this before and he is okay now.
 
  Which question is the priority for the nurse to ask the client's wife?
  1. Does your husband have diabetes?
  2. Was your husband especially active yesterday?
  3. Has your husband ever had a seizure?
  4. What kind of street drugs did your husband take last night?

[aham8f]

Answer to Question 1

Correct Answer: 3,4
Rationale 1: Since there are many side effects to antiepileptic medications, single drug therapy is the goal for pregnant clients.
Rationale 2: Women who have epilepsy have a reduced fertility rate, and some do not ovulate.
Rationale 3: Valproic acid (Depakote) is pregnancy category D.
Rationale 4: Folic acid supplementation is important for all women who are, or wish to become, pregnant. This is especially true of women who are epileptic because many antiepileptic medications cause folic acid deficiency.
Rationale 5: Women who are epileptic can and do conceive and deliver healthy babies. The nurse should not discourage this client, but should provide information to the client and then support the client's choice.
Global Rationale: Valproic acid (Depakote) is pregnancy category D. Folic acid supplementation is important for all women who are, or wish to become, pregnant. This is especially true of women who are epileptic because many antiepileptic medications cause folic acid deficiency. Since there are many side effects to antiepileptic medications, single drug therapy is the goal for pregnant clients. Women who have epilepsy have a reduced fertility rate, and some do not ovulate. Women who are epileptic can and do conceive and deliver healthy babies. The nurse should not discourage this client, but should provide information to the client and then support the client's choice.

Answer to Question 2

Correct Answer: 3
Rationale 1: While high blood glucose levels might result in a comatose state, it would be unlikely for the client to be okay without intervention.
Rationale 2: The occurrences described by this client's wife are unlikely to be a result of simple exhaustion.
Rationale 3: Being difficult to awaken and sonorous respirations are findings associated with the postictal state common after seizure activity. Persons experiencing seizures may be incontinent of urine or stool. When the postictal state passes, the client may appear normal or okay.
Rationale 4: Confronting the wife with an accusation that her husband uses illegal drugs may shut down the communication necessary to determine the etiology of the client's illness.
Global Rationale: Being difficult to awaken and sonorous respirations are findings associated with the postictal state common after seizure activity. Persons experiencing seizures may be incontinent of urine or stool. When the postictal state passes, the client may appear normal or okay. While high blood glucose levels might result in a comatose state, it would be unlikely for the client to be okay without intervention. The occurrences described by this client's wife are unlikely to be a result of simple exhaustion. Confronting the wife with an accusation that her husband uses illegal drugs may shut down the communication necessary to determine the etiology of the client's illness.