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.
You might also like to view...
A nurse who is applying eyedrops to a client holds pressure against the corner of the eye nearest the nose after instilling the drops. The client asks what the nurse is doing. What response by the nurse is best?
a. "Doing this allows time for absorption." b. "I am keeping the drops in the eye." c. "This prevents systemic absorption." d. "I am stopping you from rubbing your eye."
What is the major ethical concern of an expert witness?
1. The expert witness has an obligation to "fill in the blanks" in the medical record. 2. The expert witness must stay objective and unbiased in the work. 3. The expert witness must make a logical and fair decision at trial. 4. The expert witness must explain that unexpected outcomes sometimes occur in health care.
The nurse is migrating from a developing nation to a developed nation. This migration ultimately benefits the nurse's home country if the nurse: (Select all that apply.)
A) Returns to the home country with advanced practice skills B) Returns to the home country and teach others what was learned C) Shares with the new coworkers nursing practices unique to the nurse's home country D) Earn more money in the position in the new country E) Is safer from exposure to HIV in the new country
When the nurse asks a 68-year-old patient to stand with his feet together and arms at his side with his eyes closed, he starts to sway and moves his feet farther apart. The nurse would document this finding as:
a. Ataxia. b. Lack of coordination. c. Negative Homans sign. d. Positive Romberg sign.