The nurse is talking with a client who was just prescribed ...

[Garrulous]

The nurse is talking with a client who was just prescribed zonisamide (Zonegran). Which client statement should the nurse immediately discuss with the client's health care provider?
 
  Standard Text: Select all that apply.
  1. Did I mention that I used to take phenobarbital for my seizures?
  2. I forgot to tell the doctor that I am allergic to sulfa drugs.
  3. I have lactose intolerance, so I can't drink milk.
  4. My husband and I plan to have a baby in a couple of years.
  5. My husband and I are leading a 20-mile bicycle tour next weekend for the company we have just started.

Question 2

The client is receiving carbamazepine (Tegretol) for control of seizures. The client tells the nurse she plans to become pregnant. Which response by the nurse is the most appropriate?
 
  1. Please talk to your doctor; this drug is contraindicated in the pregnancy.
  2. Your medication dose will need to be decreased during your pregnancy.
  3. Your medication dose will need to be increased during your pregnancy.
  4. Please talk to your doctor; you will need a safer drug like valproic acid (Depakene).

[gasdhashg]

Answer to Question 1

Correct Answer: 2,5
Rationale 1: There is no indication that previous phenobarbital use is problematic with the use of zonisamide (Zonegran).
Rationale 2: Zonisamide (Zonegran) is an oral sulfonamide.
Rationale 3: There is no indication that inability to drink milk is problematic with the use of zonisamide (Zonegran).
Rationale 4: Zonisamide (Zonegran) is pregnancy category C.
Rationale 5: The most common adverse effects of zonisamide (Zonegran) include dizziness, ataxia, and fatigue. These effects may be problematic for the owner of a company that promotes bicycle touring.
Global Rationale: Zonisamide (Zonegran) is an oral sulfonamide. Since the client has an allergy to sulfa, the nurse would need to report this to the health care provider. The most common adverse effects of zonisamide (Zonegran) include dizziness, ataxia, and fatigue. These effects may be problematic for the owner of a company that promotes bicycle touring. There is no indication that previous phenobarbital use or the inability to drink milk is problematic with the use of zonisamide (Zonegran). Zonisamide (Zonegran) is pregnancy category C.

Answer to Question 2

Correct Answer: 1
Rationale 1: Carbamazepine (Tegretol) falls under pregnancy category D and is contraindicated in pregnancy.
Rationale 2: The medication does not need to be decreased; it might need to be stopped.
Rationale 3: The medication does not need to be increased; it might need to be stopped.
Rationale 4: Valproic acid (Depakene) is also a pregnancy category D drug and is contraindicated during pregnancy.
Global Rationale: Carbamazepine (Tegretol) falls under pregnancy category D and is contraindicated in pregnancy. The medication does not need to be decreased or increased; it might need to be stopped. Valproic acid (Depakene) is also a pregnancy category D drug and is contraindicated during pregnancy.

[Garrulous]

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