A 20-kg child has been taking valproic acid [Depakote] for 1 week to treat a seizure disorder. The child is receiving 200 mg PO twice daily. The child's parents report no improvement in sei-zure activity
The nurse will anticipate that the provider will order which change in this child's drug regimen? a. Adding another seizure medication to supplement the valproic acid
b. Changing to phenytoin [Dilantin] since the valproic acid is not effective
c. Increasing the dose of valproic acid to 300 mg PO twice daily
d. Increasing the dose of valproic acid to 200 mg three times daily
C
Valproic acid is given initially at a dose of 5 to 15 mg/kg/day, administered in two divided doses. This child is receiving 400 mg/day, which is 10 mg/kg/day. The dosage should be increased by 5 to 10 mg/kg/day each week until optimal levels are achieved up to a maximum dose of 60 mg/kg/day. At this point, adding another AED or changing to another AED is not recommended. Increasing the dose to three times daily is not recommended.
You might also like to view...
A client approaches the nurse grimacing, talking in a whisper, and waving his arms. Which of the following actions best demonstrates the nurse's ability to develop a therapeutic relationship?
1. Greet the client by name to demonstrate caring. 2. Assist the client to leave the area to prevent distress to others. 3. Ignore the client to convey disapproval of the behavior. 4. Confront the client about the behavior to encourage insight.
Initial post-percutaneous transluminal coronary angioplasty (post-PTCA) laboratory blood tests the nurse would need to monitor would be
A) prothrombin time. B) cardiac enzymes. C) serum glucose. D) Both a and b are correct.
The most important nursing diagnosis that must be considered when taking care of clients involved in a disaster is:
1. Caregiver Role Strain, Risk for 2. Nutrition, Less than Body Requirements 3. Pain, Acute 4. Tissue Integrity, Impaired
The nurse is providing postmortem care, and elevates the client's head in order to avoid discoloration of the face secondary to which process?
1. Rigor mortis 2. Livor mortis 3. Algor mortis 4. Post mortis