A nurse is providing teaching to a patient newly diagnosed with partial seizures who will begin taking oxcarbazepine [Trileptal]. The patient also takes furosemide [Lasix] and digoxin [Lanoxin]
Which statement by the patient indicates understanding of the teaching? a. "I may need to increase my dose of Tri-leptal while taking these medications."
b. "I may develop a rash and itching, but these are not considered serious."
c. "I should report any nausea, drowsiness, and headache to my provider."
d. "I should use salt substitutes instead of real salt while taking these drugs."
C
Oxcarbazepine can cause clinically significant hyponatremia in 2.5% of patients. If oxcarbazepine is combined with other drugs that reduce sodium, the patient should be monitored. Signs of hyponatremia include nausea, drowsiness, confusion, and headache, and patients should be taught to report these symptoms. Increasing the dose of oxcarbazepine is not indicated. Rashes can indicate a serious drug reaction, and providers should be notified so that the oxcarbazepine can be withdrawn. Salt substitutes would compound the problem of hyponatremia.
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