A patient who takes carbamazepine (Tegretol) for a seizure disorder is seen by a primary care NP for a routine physical examination. A complete blood count (CBC) reveals a low white blood cell (WBC) count. The NP should:
a. order a WBC differential.
b. discontinue the carbamazepine.
c. reassure the patient that this effect is temporary.
d. decrease the carbamazepine dose and recheck the CBC in 2 weeks.
A
A benign leukopenia associated with carbamazepine is common and is reversible and dose-related. A WBC differential should be performed before changing the drug regimen.
You might also like to view...
You are the community-based nurse who acts as case-manager for a small town about 60 miles from a major health care center. What is the most important factor of community-based nursing you should be knowledgeable about?
A) Eligibility requirements for services B) Community resources available to patients C) Transportation costs to the medical center D) Possible charges for any services provided
Thrush occurs as white patches surrounded by erythematous tissue in oral mucosa. The microorganism that causes this is:
A. Candida B. Herpes simplex I C. Coxsackie virus D. Herpes zoster
A patient has decided to explore palliative care. After this decision is announced, the nurse notices that not all the disciplines of the healthcare team seem to be supportive of the decision. What action by the nurse is indicated?
1. Contact the physician to report the discrepancies in the plan of care. 2. Discuss the patient's wishes in the next multidisciplinary meeting. 3. Develop a plan of care and distribute it to the other disciplines of the healthcare team. 4. Advise the patient to contact the social services department.
Which condition is a type II hypersensitivity reaction?
a. Allergic rhinitis b. Positive purified protein derivative (PPD) test for tuberculosis c. Transfusion reaction to improper blood type d. Serum sickness after receiving immune globulin