A patient is going to be started on valproic acid (Depakote) for seizures and tells the nurse during the health history, "I drink a six-pack of beer daily and two to three six-packs on weekends." The priority nursing action would be to
a. obtain plasma levels of valproic acid (Depakote).
b. determine other drug-to-drug interactions.
c. obtain liver function studies.
d. obtain serum creatinine levels.
ANS: C
The priority nursing action for a patient with a history of chronic alcohol use would be to obtain baseline liver function tests; the patient may have an impaired liver, which may progress quickly to hepatotoxicity if he takes valproic acid.
The patient has not yet begun therapy with Depakote, therefore a level is not indicated.
The priority nursing concern is to assess the liver before beginning valproic acid therapy.
Hepatotoxicity, not nephrotoxicity, is a concern when administering valproic acid.
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