Which response by the nurse is accurate when a patient who has been on lamotrigine (Lamictal) for seizure control reports a skin rash and urticaria?
a. Reassure the patient that this is a common adverse effect of the medication and not to worry.
b. Instruct the patient to discontinue use of the drug immediately.
c. Instruct the patient to decrease the dosage of the medication until the rash disappears.
d. Advise the patient that this adverse effect usually resolves but should be reported to the health care provider.
ANS: D
The nurse is not authorized to recommend dosage changes to the patient. The nurse should not trivialize the patient's concern about the adverse effect; it is common only in 10% of patients who take lamotrigine and can lead to more serious adverse effects. The nurse should not recommend discontinuing the medication without orders from the health care provider. This is not a common adverse effect and should be monitored. Approximately 10% of patients receiving lamotrigine develop a skin rash in the first 4 to 6 months of therapy. The health care provider should be notified promptly because the rash could be an indicator of a more serious condition.
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