Questions: A nurse is teaching a client who has a prescription for carbamazepine. Which of the following instructions should the nurse include to help the client avoid adverse effects of this medication? Begin taking the medication at a low dosage. Discontinue the medication immediately if diarrhea occurs. Have serum glucose levels checked regularly. Take the medication on an empty stomach.

The answer is the first one: Begin taking the medication at a low dosage.

Explanation for each option:

1. Begin taking the medication at a low dosage.

   • This is correct. Starting at a low dosage and gradually increasing it helps minimize the risk of adverse effects, which is a common practice with medications like carbamazepine.

2. Discontinue the medication immediately if diarrhea occurs.

   • This is incorrect. While diarrhea can be a side effect, discontinuing the medication abruptly can lead to withdrawal symptoms or a return of the condition being treated. It's important to consult a healthcare provider before stopping the medication.

3. Have serum glucose levels checked regularly.

   • This is incorrect. Carbamazepine is not typically associated with affecting glucose levels, so regular glucose monitoring is not a standard precaution for this medication.

4. Take the medication on an empty stomach.

   • This is incorrect. Carbamazepine is usually taken with food to help reduce gastrointestinal side effects.

In summary, starting at a low dosage is a key strategy to help avoid adverse effects when beginning carbamazepine.