The camp nurse has been called to the field outside the recreation center. As the nurse arrives, there is a large crowd that begins to separate. The nurse notes that one of the campers is lying on the ground, and the camper’s arms and legs are thrashing back and forth. The nurse also notes a small cut above the camper’s right eye. The nurse recognizes the camper as one who comes to see her every day for medication administration, and the nurse remembers that the medication the camper takes is taking an antiepileptic medication called phenytoin (Dilantin).
Explain the goal of antiepileptic drug therapy and why many patients have to take these medications for life.
The camper is transferred to a local emergency department, where she is stabilized. A blood level of Dilantin is drawn, and the result is 6 mcg/mL. How will the nurse interpret this finding? What adjustments would the nurse expect the health care provider to make based on this blood level? What is considered a therapeutic blood level for Dilantin? Why does the drug need to be “therapeutic?” Explain.
Second case study -Chapter 17
The nurse is conducting a class on smoking cessation. The nurse reviews the effects of nicotine on all body systems and then addresses the various approaches to smoking cessation. In addition to non-pharmacologic approaches, the nurse also provides information on the drug varenicline (Chantix).
How does Chantix assist with smoking cessation? How does it differ from other products such as bupropion (Zyban) and nicotine gum? Explain.
One of the participants remarks that there have been reports of patients who are taking Chantix exhibiting unusual behavior. How will the nurse respond? What are the common side effects associated with this medication?
Another participant asks, “What is the difference between a patch, chewing gum, or a nasal spray?” What information (including advantages and disadvantages of each route) will the nurse share with the group of participants? Be very specific.