A nurse is caring for a patient who has been taking an antiepileptic drug for several weeks. The nurse asks the patient if the therapy is effective. The patient reports little change in seizure frequency. What will the nurse do?
a. Ask the patient to complete a seizure frequency chart for the past few weeks.
b. Contact the provider to request an order for serum drug levels.
c. Reinforce the need to take the medications as prescribed.
d. Request an order to increase the dose of the antiepileptic drug.
ANS: B
If medication therapy is not effective, it is important to measure serum drug levels of the medication to determine whether therapeutic levels have been reached and to help monitor patient compliance. Patients should be asked at the beginning of therapy to keep a seizure frequency chart to help deepen their involvement in therapy; asking for historical information is not helpful. Until it is determined that the patient is not complying, the nurse should not reinforce the need to take the medication. Until the drug level is known, increasing the dose is not indicated.
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