Practice Question
A nurse is teaching a patient with newly diagnosed seizure disorder about lamotrigine (Lamictal). Which patient statement indicates the need for immediate follow-up by the nurse?
Answer Choices:
Correct Answer:
"l have a red rash on my chest that's starting to blister."
Rationale:
🔹 Lamotrigine is associated with serious cutaneous reactions, including Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).
🔹 Early signs often include a new rash, particularly if red, widespread, painful, or blistering, sometimes with mucosal involvement.
🔹 A blistering rash is an emergency finding that requires immediate discontinuation of lamotrigine and urgent medical evaluation.
🔹 Delayed response can result in life-threatening skin detachment, systemic illness, and high mortality, especially if the reaction progresses.
🔹 Therefore, this statement indicates a medical emergency and needs immediate follow-up from the nurse and provider.
"I've been feeling more tired lately and need extra naps during the day."
🔹 Fatigue and somnolence are relatively common central nervous system side effects of many antiepileptic drugs, including lamotrigine.
🔹 Although bothersome, this type of tiredness is generally non–life-threatening and can often be managed with dose adjustment or supportive advice.
🔹 The nurse should still assess onset, severity, and impact on daily functioning, but it does not usually require emergency intervention.
🔹 Education can focus on safety, such as avoiding activities requiring high alertness until the patient knows how the medication affects them.
🔹 Compared to a blistering rash, this symptom is expected and manageable, so it does not represent the most urgent concern.
"I developed a mild headache after starting the medication."
🔹 Headache is a known and relatively common mild adverse effect of lamotrigine and many other antiepileptics.
🔹 The nurse should explore onset, location, intensity, and response to simple measures, but mild headache alone typically does not signal a severe reaction.
🔹 This side effect frequently improves over time as the body adjusts to the medication, especially if dosage was titrated gradually.
🔹 Symptomatic relief with hydration, rest, or provider-approved analgesics may be sufficient if the headache is not worsening or associated with other neurologic changes.
🔹 Because it is not suggestive of SJS/TEN or major toxicity, this complaint does not require immediate emergency follow-up compared to a blistering rash.
"Sometimes I feel dizzy when I stand up too quickly."
🔹 Dizziness or lightheadedness, especially on standing, can occur due to CNS effects or mild orthostatic changes with antiepileptic drugs.
🔹 This symptom warrants teaching the patient to change position slowly, maintain adequate hydration, and report persistent or worsening episodes.
🔹 The nurse should assess for falls risk and advise safety precautions at home, particularly in older adults or those on multiple medications.
🔹 While uncomfortable and potentially risky if severe, this dizziness is generally not an immediate life-threatening adverse effect.
🔹 Compared with a new blistering rash, this symptom is lower priority and does not indicate the severe cutaneous reaction associated with lamotrigine.
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This question is from Custom- 2201 FA25 Unit 4 Exam-South LA CC Lafayette RN which contains 31 questions.
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Custom- 2201 FA25 Unit 4 Exam-South LA CC Lafayette RN
31 Questions
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- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI Adult Health
- Answer Choices: 4