A nurse is caring for a 14-year-old patient with epilepsy. The child takes phenytoin and started taking Lamictal (lamotrigine) 50 mg/day approximately 10 days ago. The child's mother calls to report a newly noted rash across the girl's face and arms. Which of the following statements by the nurse is best?
A) "Did your daughter use a new soap?"
B) "Has your daughter been exposed to poison ivy or other plant irritants?"
C) "Do not give the Lamictal; your daughter will need to be seen by the doctor today."
D) "This is commonly seen with Lamictal. A mild soap and calamine lotion may reduce any itching."

Question

Quizplus · Accepted Answer

The rash may be a sign of a serious allergic reaction to lamotrigine, known as Stevens-Johnson syndrome or toxic epidermal necrolysis. The nurse should advise the mother to not give any more Lamictal and to bring the child in to be seen by a doctor immediately. Asking about soap or plant exposures is not relevant given the timing and symptoms of the rash. Offering symptomatic treatment without a physician assessment may delay appropriate care and potentially worsen the child's condition.

A Nurse Is Caring for a 14-Year-Old Patient with Epilepsy