CHAPTER 53: PREP U

A 32-year-old female client is taking tizanidine (Zanaflex) for spasticity related to her multiple sclerosis. The nurse will inform the client and her husband that the adverse effect that poses the greatest safety risk to the client is: constipation. dry mouth. fatigue. hypotension.

hypotension.

A client in the clinic with a history of epilepsy has just tested positive for pregnancy. What is the nurse's next action? Advise the client to continue her current medication for epilepsy. Discuss the most serious birth defects that may occur due to treating epilepsy during pregnancy. Consult with the primary health care provider. Explain how to taper off her seizure medication as the risk for seizures decreases during pregnancy.

Consult with the primary health care provider. The use of anticonvulsants is not discontinued in pregnant women with a history of major seizures because of the danger of precipitating status epilepticus. However, when seizure activity poses no serious threat to the pregnant woman, the primary health care provider may consider discontinuing use of the drug during pregnancy.

The nurse has administered anakinra to a client. Which assessment finding should the nurse prioritize? Constipation Abdominal pain Retinal changes Pancytopenia

Pancytopenia Constipation is a potential adverse reaction to cyclobenzaprine. Retinal changes are potential adverse reactions to hydroxychloroquine.

The nurse is caring for a 59 year-old female client who was diagnosed with multiple sclerosis two years ago. In recent weeks, the client has developed increasing muscle spasticity and the care team is considering the use of dantrolene. What assessment question should the nurse prioritize? "Are you on hormone replacement therapy?" "Have you had a hysterectomy?" "Have you ever been treated for fibromyalgia?" "At what age did you begin menopause?"

"Are you on hormone replacement therapy?" The combination of dantrolene and estrogen creates an unacceptable risk for hepatotoxicity. For this reason, concurrent use of dantrolene and hormone therapy would be unsafe.

One week ago, a client began taking ethosuximide 500 mg/day PO for the treatment of absence seizures. The client reports gastrointestinal (GI) upset after taking with the drug. What health education should the nurse provide? "Take the drug 1 hour before or 2 hours after a meal to minimize stomach upset." "Taking over-the-counter antacids before and after the dose helps for some clients." "Try taking your pills at the same time as you eat some food." "Contact your health care provider to see if there's an alternative drug that would work for you."

"Try taking your pills at the same time as you eat some food."

A client has been admitted to the emergency department and is experiencing tonic-clonic seizures. What intervention should the nurse prioritize? Administration of phenytoin IV as prescribed Administration of gabapentin PO as prescribed Assessment of the client's renal and hepatic function Establishing a therapeutic relationship with the client

Administration of phenytoin IV as prescribed Phenytoin IV is among the most common treatments for tonic-clonic seizures;

Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation? Baclofen Allopurinol Alendronate Hydroxychloroquine

Baclofen Allopurinol would be administered to treat gout. Alendronate would be administered to treat osteoporosis. Hydroxychloroquine would be used to treat rheumatoid arthritis.

A client with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered? Baclofen Carisoprodol Chlorzoxazone Cyclobenzaprine

Baclofen Baclofen is used for the treatment of muscle spasticity associated with spinal cord injuries. Carisoprodol is used for the relief of discomfort of acute musculoskeletal conditions. Chlorzoxazone is used for the relief of discomfort of acute musculoskeletal conditions. Cyclobenzaprine is used for the relief of discomfort of acute musculoskeletal conditions.

A client with a musculoskeletal disorder is unable to ambulate due to significant pain and immobility issues. Which care should the nurse prioritize for this client? Changing the client's position every 2 hours Changing the bed linens every 2 hours Encouraging the client to walk with assistance Encouraging the client to exercise with assistance

Changing the client's position every 2 hours

The nurse is administering phenytoin to a client who is also receiving a continuous nasogastric enteral feeding and is aware of what possible effect? Increasing absorption of the AED Decreasing the absorption of the AED Not affecting absorption of the AED Precipitating signs of overdosage

Decreasing the absorption of the AED

When developing a teaching plan for a client who is to receive carisoprodol, which sign or symptom would the nurse include as a common adverse reaction? Drowsiness Dyspnea Hypertension Tachycardia

Drowsiness Drowsiness is the most common adverse reaction to skeletal muscle relaxants like carisoprodol that the nurse should discuss with the client.

An older adult resident of a long-term care facility is experiencing muscle spasticity and has just been prescribed a centrally acting skeletal muscle relaxant. The client has comorbidities of early stage Alzheimer's disease and chronic obstructive pulmonary disease (COPD). What nursing action should the nurse prioritize for adding to the client's care plan? Falls prevention measures Seizure precautions Continuous pulse oximetry Deep breathing and coughing exercises

Falls prevention measures The client's combination of CNS depression from the muscle relaxant and an underlying cognitive deficit creates a risk for falls.

An older adult client has been prescribed an antiseizure medication and is experiencing central nervous system depression. What is the nurse's most appropriate action? Implement falls precautions Monitor vital signs hourly while the client is awake Maintain the client on bed rest Make a referral to occupational therapy

Implement falls precautions CNS depression creates a risk for falls, especially in older clients.

A client has received a prescription for baclofen. The home care nurse would schedule which laboratory tests to monitor this client? CBC and electrolytes Liver function tests Cardiac function tests Hemoglobin and hematocrit

Liver function tests

What should the nurse include as a possible adverse effect when teaching a client about phenytoin? Liver toxicity Diarrhea Increased white blood cell count Physical dependence

Liver toxicity adverse affects of phenytoin are liver toxicity, constipation, bone marrow suppression and leukopenia physical dependence is an adverse effect of benzodiazepines and barbiturates.

The nurse is part of a team caring for a client in status epilepticus. What will the pharmacologic portion of the treatment consist of? Lorazepam given by mouth. Lorazepam given intravenously. Diazepam given by mouth. Diazepam given by intramuscular injection.

Lorazepam given intravenously. Status epilepticus can be treated with IV lorazepam or IV diazepam.

An older adult is prescribed a skeletal muscle relaxant for reports of neck pain. What is the top priority of care for the nurse to teach the family? Administer the medication with meals. Monitor the client before ambulating. Instruct on how to assess client's pain level. Give the medication at the same time each day

Monitor the client before ambulating.

A nurse is caring for a patient prescribed phenobarbital for status epilepticus. What intervention should the nurse perform when the patient has been administered the drug? Observe respirations frequently. Monitor blood glucose levels. Monitor body temperature. Record fluid input and output.

Observe respirations frequently.

After teaching a group of nursing students about seizures, the instructor determines that the teaching was successful when the group identifies seizures that do not impair consciousness but can involve the senses or motor ability as which type? Partial seizures Generalized seizures Tonic-clonic seizures Myoclonic seizures

Partial seizures Generalized seizures involve loss of consciousness during the seizure. Tonic-clonic seizures are a type of generalized seizure involving alternate contraction and relaxation of the muscles, loss of consciousness, and abnormal behavior. Myoclonic seizures involve sudden, forceful contractions of single or multiple groups of muscles.

A nurse is administering lorazepam to a client with status epilepticus. The nurse will be prepared to administer which additional drug to treat the status epilepticus for the next several hours? Ethosuximide Phenytoin Ethotoin Zonisamide

Phenytoin

A nurse is caring for a client who is receiving cyclobenzaprine. The nurse would expect to assess which finding as indicating the therapeutic effect of the drug? Reduction of muscle spasm Prevention of seizure Relief from anxiety Relief from nervous disorder

Reduction of muscle spasm

A nurse is caring for a patient who is receiving cyclobenzaprine. Which of is the action of the drug on the patient? Reduction of muscle spasm Prevention of convulsion Relief from anxiety Relief from nervous disorder

Reduction of muscle spasm

For which patient would cyclobenzaprine not be prescribed for muscle spasms? The patient who underwent a lumbar laminectomy and is having back spasms The patient who is having muscle spasms because of cerebral palsy The patient who is having muscle spasms in the left leg after a fracture The patient who strained a quadriceps muscle playing baseball

The patient who is having muscle spasms because of cerebral palsy Cyclobenzaprine is used to manage muscle spasms associated with acute musculoskeletal disorders, such as low back strain, muscle tenderness, or movement restriction due to musculoskeletal conditions. It is also used as supportive therapy in patients with tetanus or fibromyalgia. Cyclobenzaprine is ineffective for treating spasticity associated with cerebral or spinal cord disease or in children with cerebral palsy.

In a person being treated for a diagnosed seizure disorder, what is the most common cause of status epilepticus? abusing drugs and/or alcohol abruptly stopping the antiseizure medications hypoxia-inducing experience experiencing a brain injury

abruptly stopping the antiseizure medications In a person taking medications for a diagnosed seizure disorder, the most common cause of status epilepticus is abruptly stopping AEDs.

Kate is experiencing status epilepticus. The prescriber orders IV diazepam. What special precautions need to be taken by a nurse to administer IV diazepam? Administer the drug very slowly, no faster than 5 mg/min. Administer the drug through an IV pump. Dilute the drug with 5 to 10 mL normal saline. Administer the drug in the small veins in the dorsum of the hand or the wrist.

administer the drug very slowly, no faster than 5 mg/min.

The nurse is providing education for a client who has been prescribed phenytoin. What adverse reactions should the nurse discuss in the teaching? Select all that apply. ataxia nausea lethargy gingival hyperplasia increased seizure activity

ataxia nausea lethargy gingival hyperplasia

The nurse is caring for a client who has a disorder of muscle contraction and relaxation. The nurse should prioritize the assessment of what laboratory value? calcium chloride magnesium potassium

calcium

A client with a history of malignant hyperthermia is scheduled for surgery. Which agent would the nurse most likely expect to administer? Botulinum toxin type B Dantrolene Baclofen Methocarbamol

dantrolene

A nurse administers carisoprodol to a client for the treatment of an acute musculoskeletal condition. The nurse would be alert for which adverse effect after administering the drug? Insomnia Anxiety Constipation Drowsiness

drowsiness

A client is to receive ethotoin. The nurse would expect to administer this drug by which route? Oral Rectal Intramuscular Intravenous

oral

A nurse is caring for a client with trigeminal neuralgia at a health care facility. The health care provider has prescribed carbamazepine. In which case is the use of carbamazepine contraindicated in clients with: nervous breakdown. renal impairment. hearing impairment. respiratory depression.

renal impairment.

What type of seizure activity is characterized by generalized tonic-clonic convulsions lasting for several minutes during which the client does not regain consciousness? status epilepticus akinetic motor febrile

status epilepticus

The nurse examines reviews the medical administration record and notes the medication lamotrigine needs to be administered. The client has developed a red scaly rash with fluid-filled blisters and purpuric areas all over the client's body. Which action(s) should the nurse take? Select all that apply. Notify the primary care provider immediately. Assess vital signs. Administer the dose of lamotrigine. Document the skin assessment. Cleanse affected areas with soap and water.

Notify the primary care provider immediately. Document the skin assessment. Assess vital signs.

A client has been prescribed phenytoin for the treatment of seizures. How should the nurse most accurately determine whether the client has therapeutic levels of the medication? Review the client's laboratory blood work. Assess the client carefully for adverse effects. Monitor the client for seizure activity. Assess the client's cognitive status.

Review the client's laboratory blood work. Measuring serum drug levels evaluates whether the therapeutic range of circulating drug can be found in the serum.

Assessment of a client receiving anticonvulsant therapy reveals sore throat, chills, fever, gingival bleeding, and bruising. Which nursing diagnosis would the nurse most likely prioritize? Risk for impaired skin integrity Impaired oral mucous membranes Risk for injury Risk for infection

Risk for infection The assessment findings suggest pancytopenia, so risk for infection would be most likely. Risk for impaired skin integrity would be appropriate if the client developed a rash. Impaired oral mucous membranes would be appropriate if the client was exhibiting signs of gingival hyperplasia. Risk for injury would be appropriate if the client was experiencing drowsiness, ataxia, and vision disturbances related to the drug therapy.

When does a client with spinal cord injury-associated spasticity require treatment for this condition? Ambulation is possible only with an assistive device. Safety, mobility, and activities of daily living are impaired. Pain is present in all affected extremities. Orthopedic procedures are indicated.

Safety, mobility, and activities of daily living are impaired.

The primary health care provider prescribes adalimumab. The nurse would prepare to administer this drug by which route? Orally Intramuscularly Subcutaneously Intravenously

Subcutaneously

The primary health care provider prescribes adalimumab. The nurse would prepare to administer this drug by which route? Orally Intramuscularly Subcutaneously Intravenously

Subcutaneously

During an in-service, the charge nurse explains to the licensed vocational nurse (LVN) that there are six categories of anticonvulsants with different mechanisms of action. The LVN demonstrates understanding of the action of the miscellaneous drug, gabapentin, by stating which of the following? "This drug acts in the postsynapses in the motor cortex of the brain." "Gabapentin elevates the seizure threshold." "Gabapentin depresses the motor cortex." "This drug is a gamma-aminobutyric acid (GABA) agonist."

This drug is a gamma-aminobutyric acid (GABA) agonist." Hydantoins stabilize the hyperexcitability postsynaptically in the motor cortex of the brain. Succinimides depress the motor cortex, thus raising the seizure threshold. Benzodiazepines elevate the seizure threshold by decreasing postsynaptic excitation.

Which of the following drugs are approved for use in MS clients with severe spasticity? Metaxalone and Carisoprodol Dantrolene and Carisoprodol Tizanidine and Dantrolene Tizanidine and Baclofen

Tizanidine and Baclofen Baclofen and tizanidine are approved for spasticity in people with MS.

An adolescent taking oral contraceptives has been prescribed an anticonvulsant medication. The nurse should tell the client to do which? use another form of birth control, such as condoms. watch for signs of hyperglycemia, such as increased thirst, hunger, and urination. be aware that these two drugs will interact and increase seizure activity initially. stop driving due to the increased depressant effects and excessive drowsiness.

use another form of birth control, such as condoms. Anticonvulsants and oral contraceptives interact, leading to decreased effectiveness of birth control.

A client has been prescribed baclofen and will be taking the drug on an outpatient basis. The client asks the nurse if it is still okay to drink wine with meals or end the day with a "nightcap." What is the nurse's best response? "The combination of baclofen and alcohol could depress your nervous system to a dangerous level." "If you combine baclofen and alcohol you could suffer a severe allergic-type reaction." "It's best to keep your alcohol intake to a low level when you're taking muscle relaxants." "You're not permitted to drink alcohol while you're taking baclofen."

"The combination of baclofen and alcohol could depress your nervous system to a dangerous level."

The nurse is monitoring the serum carbamazepine level of a client. Which result would lead the nurse to notify the prescriber that the client most likely needs an increased dosage? 2 mcg/mL 4 mcg/mL 6 mcg/mL 8 mcg/mL

2 Therapeutic serum carbamazepine levels range from 4 to 12 mcg/mL. Therefore, a level under 4 mcg/mL would suggest that the drug has not reached therapeutic levels, so the dosage may need to be increased.

The client is taking cyclobenzaprine for muscle spasms secondary to an injury to the lumbar spine that occurred while lifting a motor at work. The client is being seen for a follow-up visit by the health care provider. The client reports dry mouth, blurred vision, and constipation. Why is the client having these side effects from cyclobenzaprine? Cyclobenzaprine produces an anticholinergic response Cyclobenzaprine acts in the peripheral nervous system Cyclobenzaprine has an effect at the neuromuscular junction Cyclobenzaprine is structurally similar to amitriptyline

Cyclobenzaprine produces an anticholinergic response Cyclobenzaprine relieves muscle spasms through a central action, possibly at the level of the brain stem, with no direct action on the neuromuscular junction or the muscle involved. The common adverse effects of cyclobenzaprine are related to its CNS depression and anticholinergic activity. The most common adverse effects are drowsiness, dizziness, and dry mouth.

A 29-year-old client who experienced a lower back injury has seen his range of motion decrease and his pain increase over the past several weeks. As a result, he has been prescribed cyclobenzaprine. What nursing diagnosis should the nurse prioritize in light of the client's drug regimen? Risk for Injury related to CNS depression Risk for Impaired Swallowing related to adverse neuromuscular effects Risk for Sexual Dysfunction related to endocrine changes Risk for Ineffective Airway Clearance related to increased secretions and decreased lung function

Risk for Injury related to CNS depression

A 50-year-old woman has begun taking baclofen to treat her recently diagnosed multiple sclerosis (MS). What teaching point should the nurse provide to the patient about her new drug regimen? "It's best to avoid taking a dose of baclofen unless your spasticity becomes impossible to manage." "Make sure that you don't stop taking baclofen suddenly because it might cause your symptoms to rebound quite sharply." "Even though baclofen is a drug that's available over the counter, it still has the potential to cause serious adverse effects if taken incorrectly." "You'll likely have to stop taking your other medications for a week to ten days before starting to take baclofen."

"Make sure that you don't stop taking baclofen suddenly because it might cause your symptoms to rebound quite sharply."

A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman's nurse provide? "This will likely relieve your muscle spasms but you'll probably develop a certain amount of dependence on the drug over time." "We'll need to closely monitor your blood sugar levels for the next week." "There's a small risk that you might experience some hallucinations in the first few days that you begin taking this drug." "You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity."

"You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity. Dantrolene causes weakness because of its generalized reduction of muscle contraction

A 36-year-old man has been taking extended-release carbamazepine for 1 year. He is in the clinic every 3 months for follow-up visits, which include a drug blood level. Which of the following carbamazepine blood levels would indicate a potential risk for adverse effects? 2 mcg/mL 6 mcg/mL 10 mcg/mL 15 mcg/mL

15 The therapeutic blood level for the drug ranges from 4 to 12 mcg/mL for an adult. A level of 15 mcg/mL is higher than the therapeutic level and could cause increased adverse effects or possible toxic effects.

A nurse is aware that baclofen (Lioresal) is a centrally-acting spasmolytic that has been demonstrated to be safe and effective in the treatment of numerous disorders of muscle spasm and spasticity. The nurse should question the order if baclofen is prescribed for which of the following patients? A 22-year-old man whose muscle spasticity is attributable to a spinal cord injury that he suffered while snowboarding. A 49-year-old woman whose recent motor disturbances have culminated in a diagnosis of multiple sclerosis. A 14-year-old boy who has a diagnosis of cerebral palsy and who has experienced a recent increase in muscle spasticity. A 70-year-old man whose Parkinson disease has worsened in recent months, resulting in decreased mobility and self-care.

A 70-year-old man whose Parkinson disease has worsened in recent months, resulting in decreased mobility and self-care. Baclofen is useful in the treatment of spasticity and myoclonus resulting from disorders such as MS, cerebral palsy, and traumatic injury to the spinal cord.

A client in status epilepticus has been brought to the emergency department. The nurse should anticipate which treatment measures? Administration of oral or sublingual phenytoin Administration of intravenous lorazepam Administration of zonisamide (Zonegran) Administration of intravenous gabapentin

Administration of intravenous lorazepam

A nurse would monitor a client closely for increased CNS depressant effects when a skeletal muscle relaxant is used concomitantly with which additional drug(s)? Select all that apply. Antihistamine Oral contraceptives Alcohol Opiates Antidiabetic medications

Alcohol Opiates Antihistamine The use of a skeletal muscle relaxant and oral contraceptives may result in decreased effectiveness of the contraceptive

A client is receiving carbamazepine therapy and the client's latest serum level of the drug is 13 mcg/mL. What action is most appropriate? Anticipate a reduction in dosage Call an emergency code Contact the provider to request a one-time supplementary dose Assess the client's renal function

Anticipate a reduction in dosage A serum carbamazepine level of 13 mcg/mL is slightly over the therapeutic range of 4 to 12 mcg/mL, indicating need for a reduction in dosage

The nurse is caring for a client who is being discharged home from the rehabilitation unit. Baclofen will be discontinued, and the client will begin taking carisoprodol as an outpatient. What is the nurse's primary consideration when discontinuing the client's baclofen? The client's dose of baclofen should be gradually withdrawn over 4 to 6 weeks to prevent rebound spasticity. The client will be prescribed alternate doses of baclofen and carisoprodol over 10 days to prevent symptoms of baclofen withdrawal. Baclofen must be tapered down over 1 to 2 weeks to prevent psychoses and hallucinations. Carisoprodol will be administered while continuing baclofen until the carisoprodol level is established.

Baclofen must be tapered down over 1 to 2 weeks to prevent psychoses and hallucinations.

After teaching a group of nursing students about the various drugs used to treat musculoskeletal conditions, the instructor determines that the teaching was successful when the students correctly choose which drug as being used to treat osteoporosis? DMARDs Bone resorption inhibitors Skeletal muscle relaxants Uric acid inhibitors

Bone resorption inhibitors Disease-modifying antirheumatic drugs (DMARDs) are used to treat rheumatoid arthritis. Uric acid inhibitors are used to treat gout. Skeletal muscle relaxants are used to alleviate muscle spasms and cramping.

A client is prescribed lamotrigine for control of partial seizures. What is the most important medication teaching information the nurse should emphasize from the plan of care? Take this medication with food to prevent nausea and vomiting. A mild headache may occur while taking this medication. Contact the health care provider immediately if rash appears. Seek assistance when walking if dizziness occurs.

Contact the health care provider immediately if rash appears. GI upset, headache, rash, and dizziness are all adverse reactions of lamotrigine. The most important teaching point to emphasize is to notify the health care provider if a rash appears. A rash can develop into a Stevens-Johnson syndrome rash, a severe and potentially fatal rash.

A nurse is assessing a client who has come to the emergency department reporting back spasms. The client states a history of opioid addiction and does not want to take any drug that "puts me at risk of becoming physically dependent." Which medication would the nurse question, if ordered? Methocarbamol (Robaxin) Orphenadrine (Norflex) Cyclobenzaprine (Flexeril) Metaxalone (Skelaxin)

Cyclobenzaprine (Flexeril) The nurse would be concerned if the health care provider ordered cyclobenzaprine because long-term use of this drug may result in physical dependence. The other drugs listed are not associated with physical dependence.

When describing the action of barbiturates and barbiturate-like agents in the control of seizures, what would the nurse include? Promotion of impulse conduction Stimulation of the cerebral cortex Depression of motor nerve output Maintenance of cerebellar function

Depression of motor nerve output The barbiturates and barbiturate-like drugs depress motor nerve output, inhibit impulse conduction in the ascending reticular activating system (RAS), depress the cerebral cortex, and alter cerebellar function. They stabilize nerve membranes throughout the CNS directly by influencing ionic channels in the cell membrane, thereby decreasing excitability and hyperexcitability to stimulation.

The nurse is reviewing the results of a hospital client's serum phenytoin level, which has just become available. The results indicate that the client's phenytoin level is 17.5 mcg/mL. What is the nurse's best action? Document the fact that the nurse checked the client's phenytoin levels Contact the care provider to communicate this result Raise the client's bed rails and maintain the client on bed rest Perform a focused neurological assessment

Document the fact that the nurse checked the client's phenytoin levels The therapeutic range is 10 to 20 mcg/mL. Consequently, there is no action needed beyond documentation.

When reviewing a journal article about seizure disorders, the nurse would expect to find tonic-clonic seizures and myoclonic seizures being classified as which type of seizures? Generalized seizures Partial seizures Complex seizures Atonic seizures

Generalized seizures

Which type of seizures involves a loss of consciousness? Generalized seizures Partial seizures Somatosensory seizures Motor seizures

Generalized seizures

The nurse should closely monitor clients receiving which of the following anticonvulsants for gingival hyperplasia? Select all that apply: Carbamazepine (Tegretol) Phenytoin (Dilantin) Valproic acid (Depakote) Felbamate (Felbatol) Ethosuximide (Zarontin)

Phenytoin (Dilantin) Ethosuximide (Zarontin)

The nurse has taught a client who is receiving lamotrigine about possible adverse effects. The nurse determines that the client has understood the teaching when the client identifies a need to promptly report what adverse effect? Rash Anorexia Fatigue Signs of upper respiratory infection

RASH Lamotrigine has been associated with very serious to life-threatening rashes and the drug should be discontinued at the first sign of any rash

A client with gout is prescribed pegloticase after not responding to the usual medications. Which nursing diagnosis would the nurse determine to be most appropriate in this case? Risk for injury Acute pain Impaired comfort: gastric distress Risk for allergic response

Risk for allergic response

A 60 year-old female client has multiple sclerosis accompanied by muscle spasticity. The client has responded well to dantrolene 200 mg PO daily in divided doses. What assessment finding should the nurse prioritize for communication to the client's provider? The client's most recent laboratory results show an upward trend in AST and ALT levels The client is reluctant to participate in physical therapy this morning, when she is normally highly motivated The client tells the nurse, "I'm struggling to come to grips with the fact that I'm never going to recover." The client has gained 1.5 lbs. over the past 48 hours

The client's most recent laboratory results show an upward trend in AST and ALT levels An increase in liver enzyme levels could indicate the onset of hepatocellular damage, which is a high risk in female clients of this age.

In children, the most common form of seizure is: akinetic seizures. febrile seizures. partial seizures. absence seizures.

febrile seizures.

What is a common risk for epileptic seizures during late infancy to early childhood? learning disability fever medication overdose malnutrition

fever

A client has been diagnosed with cerebral palsy accompanied by muscle spasticity. The nurse should identify what causative factor of this client's symptoms? irreversible injury to muscle tissue imbalances between neurotransmitter levels and the levels of enzymes that modulate their reuptake inherited defects of the peripheral nervous system nerve damage within the central nervous system

nerve damage within the central nervous system Muscle spasticity is the result of damage to neurons within the central nervous system (CNS) rather than injury to peripheral structures such as the musculoskeletal system.