Question

The nurse is caring for JM, a patient who was admitted to the hospital with severe migraines. JM has been taking warfarin, a highly protein-bound anticoagulant, for atrial fibrillation. After a thorough evaluation, the neurologist has ordered valproic acid, an antiseizure medication. Valproic acid is also highly protein bound.

1. What nursing diagnosis would be appropriate for this patient?

2. What information needs to be included in the interdisciplinary health/teaching plan for this patient?

3. During a teaching session, the patient shares that he plans to start taking over-the-counter products to boost his energy. What is the nurse’s best response to the patient’s comment? Explain your answer.

Answer 1

Valproic acid is a drug which is approved for the use of neuropathic pain and migraine prophylaxis.

Gastrointestinal adverse effects are common, particularly at the start of therapy. valproic acid adverse drug reactions include hepatotoxicity, mitochondrial toxicity, hyper ammonemic encephalopathy, hypersensitivity syndrome reactions, neurological toxicity, metabolic and endocrine adverse events, and teratogenicity.

1.*Anxiety related to disease condition (migraine)

*Deficient knowledge relate to medication effects

*Imbalanced nutrition less than body requirements related anxiety about the health status

*Ineffective health maintenance related to hospitalization

*Ineffective protection related to medication and its side effects

*Ineffective coping related to deficient communication with the caregivers.

2. Here patient was given a new prescription of the drug, Valproic acid and has no previous experience with the medication, Patient has to get adequate education about the drugs being prescribed. We have to collaborate with the interdisciplinary team and describe the rationale for the therapeutic regimen to avoid compliance and thus improve the coping with the present situation and thus reduce the anxiety and other health-related behaviors.

We have to educate the patient regarding its potential benefits as well as the side effects, drug interactions etc and thus more compliance with the therapeutic regimen.

Advise the person not to take OTC drug with the prescribed drug without notifying the health care provider.

We have to plan with the interdisciplinary team to improve the communication skills of the patient (therapeutic communication)

3. The patient should not take any OTC drug without consultation with the health care provider.

As a nurse, we have to instruct the patient that to be remind cautious when taking energy boosters especially herbal products/OTC products, that it may interfere with the patient therapeutic regimen,sometimes it may cause severe interactions that may be lethal.sofirst of all before start taking OTC products as energy booster verify it with the health care provider first, thus maximize the effect of therapy and minimize the side effects with other OTC products.