Author Question: The nurse identifies Injury, Risk for as a nursing diagnosis for a client beginning therapy with ... (Read 109 times)

809779 · **on:** Jul 23, 2018

The nurse identifies Injury, Risk for as a nursing diagnosis for a client beginning therapy with verapamil (Verelan) who takes carbamazepine (Tegretol) to manage a seizure disorder

because this drug combination can result in an increased risk of which disorder?
1. Seizures
2. Confusion
3. Ataxia
4. Hypotension

Question 2

Most calcium channel blockers reduce the force of myocardial contractions. The nurse knows which drugs have this negative chronotropic effect at a therapeutic dose?

Standard Text: Select all that apply.
1. Verapamil
2. Diltiazem
3. Amlodipine
4. Felodipine
5. Nicardipine

peter · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 3
Rationale 1: The interaction of these drugs does not cause a decrease in serum concentration of carbamazepine (Tegretol), which could cause loss of seizure control.
Rationale 2: Altered mental status is not a consequence of a rise in serum carbamazepine (Tegretol) concentration.
Rationale 3: The interaction of these drugs causes an increase in serum concentration of carbamazepine (Tegretol) and could lead to falls associated with ataxia, which is an adverse effect of carbamazepine (Tegretol).
Rationale 4: An increase in serum concentration of verapamil (Verelan), which could cause hypotension, is not a consequence of the interaction of these drugs.
Global Rationale: The interaction of these drugs causes an increase in serum concentration of carbamazepine (Tegretol) and could lead to falls associated with ataxia, which is an adverse effect of carbamazepine (Tegretol). The interaction of these drugs does not cause a decrease in serum concentration of carbamazepine (Tegretol), which could cause loss of seizure control. Altered mental status is not a consequence of a rise in serum carbamazepine (Tegretol) concentration. An increase in serum concentration of verapamil (Verelan), which could cause hypotension, is not a consequence of the interaction of these drugs.

Answer to Question 2

Correct Answer: 1,2
Rationale 1: Verapamil has a negative chronotropic effect on the myocardium at a therapeutic dose.
Rationale 2: Diltiazem has a negative chronotropic effect on the myocardium at a therapeutic dose.
Rationale 3: Amlodipine has a negative chronotropic effect on the myocardium only at high doses.
Rationale 4: Felodipine has a negative chronotropic effect on the myocardium only at high doses.
Rationale 5: Nicardipine has a negative chronotropic effect on the myocardium only at high doses.
Global Rationale: Verapamil and diltiazem both have a negative chronotropic effect on the myocardium at a therapeutic dose. Amlodipine, felodipine, and nicardipine all have a negative chronotropic effect on the myocardium when prescribed at high doses.