Question

The nurse is caring for a client with epilepsy who is being treated with carbamazepine (Tegretol). Which laboratory value might indicate a serious side effect of this drug? A. Uric acid of \(5 \mathrm{mg} / \mathrm{dL}\) B. Hematocrit of \(33 \%\) C. WBC 2,000 per cubic millimeter D. Platelets 150,000 per cubic millimeter

Short answer

A) Uric acid level 5 mg/dL B) Hematocrit level 33% C) White blood cell count 2,000 per cubic millimeter D) Platelet count 150,000 per cubic millimeter Answer: C) White blood cell count 2,000 per cubic millimeter

Step-by-step solution

Understanding Carbamazepine side effects

First, let's understand the potential side effects of carbamazepine. This drug is an anticonvulsant that mainly used to treat seizures and nerve pain. Side effects of carbamazepine treatment can include gastrointestinal issues, dizziness, drowsiness, dry mouth, and hematological issues like leukopenia (low white blood cells).

Evaluate Option A - Uric acid levels

Option A states a uric acid level of \(5 \mathrm{mg} / \mathrm{dL}\). The normal range for uric acid is between \(3.4\) to \(7.0 \mathrm{mg} / \mathrm{dL}\). This value lies within the normal range and does not indicate a serious side effect.

Evaluate Option B - Hematocrit levels

Option B states a hematocrit level of \(33 \%\). The normal hematocrit range is \(36\% - 46\%\) for women and \(42\% - 52\%\) for men. Though this level is slightly below the normal range, it is not indicative of a serious side effect of carbamazepine.

Evaluate Option C - White blood cell count

Option C states a WBC count of \(2,000\) per cubic millimeter. The normal range for white blood cell count is between \(4,000\) and \(11,000\) per cubic millimeter. This value is significantly below the normal range, indicating leukopenia, which is one of the serious side effects of carbamazepine.

Evaluate Option D - Platelet count

Option D states a platelet count of \(150,000\) per cubic millimeter, which is within the normal range of \(150,000\) to \(400,000\) per cubic millimeter. This value does not indicate a serious side effect.

Conclusion

Based on the analysis above, the answer is Option C (WBC 2,000 per cubic millimeter), which indicates leukopenia, a known serious side effect of carbamazepine.