The client is prescribed valproic acid (Depakene) for treatment of seizures. The client has also been taking a daily 81 mg aspirin tablet prophylactically for a cardiac condition
Because of the use of these two drugs, the nurse closely observes the client for which occurrence?
1. Increase in seizure activity
2. Migraine headaches and generalized irritability
3. Bleeding from the gums and bruising of the skin
4. Stevens–Johnson syndrome
Correct Answer: 3
Rationale 1: Increased seizure activity is not associated with valproic acid (Depakene).
Rationale 2: Migraine headaches and generalized irritability do not result from valproic acid (Depakene) and aspirin use.
Rationale 3: Valproic acid (Depakene) can prolong bleeding time; concomitant aspirin use can cause severe bleeding.
Rationale 4: Stevens–Johnson syndrome is a side effect of valproic acid (Depakene); its occurrence is not increased with concomitant aspirin use.
Global Rationale: Valproic acid (Depakene) can prolong bleeding time; concomitant aspirin use can cause severe bleeding. Increased seizure activity, migraine headaches and generalized irritability are not associated with the combination of valproic acid (Depakene) and aspirin. Stevens–Johnson syndrome is a side effect of valproic acid (Depakene); its occurrence is not increased with concomitant aspirin use.
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