The nurse should monitor the client for gingival hyperplasia, which is an overgrowth of the gums, as an adverse effect of phenytoin. Gingival hyperplasia can cause bleeding, inflammation, and infection of the gums, and may interfere with chewing and oral hygiene¹². The nurse should advise the client to brush and floss their teeth regularly, use a soft toothbrush, and visit a dentist every 3 to 4 months²³.

Choice A is wrong because hypertension is not an adverse effect of phenytoin. Phenytoin can cause hypotension, especially when given intravenously at a high rate or in large doses⁴⁵. The nurse should monitor the client's blood pressure and heart rate and inject the medication slowly over at least 3 minutes⁵.

Choice C is wrong because diarrhea is not an adverse effect of phenytoin. Phenytoin can cause constipation, especially in elderly clients or those with reduced mobility . The nurse should encourage the client to drink plenty of fluids, eat high-fiber foods, and exercise regularly to prevent constipation.

Choice D is wrong because tachycardia is not an adverse effect of phenytoin. Phenytoin can cause bradycardia, especially when given intravenously at a high rate or in large doses⁴⁵. The nurse should monitor the client's heart rate and rhythm and inject the medication slowly over at least 3 minutes⁵.

You may develop a rash or itching. The nurse should inform the client that this drug may cause a rash or itching, which can be a sign of a serious allergic reaction or a rare but life-threatening skin condition called Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN)¹². The nurse should instruct the client to stop taking the drug and seek medical attention immediately if they develop a rash, hives, blisters, peeling skin, fever, or swollen lymph nodes²³.

Choice A is wrong because blurred vision or drowsiness are not adverse effects of carbamazepine, but rather common side effects that usually go away with time or dose adjustment¹². The nurse should advise the client to avoid driving or operating machinery until they know how the drug affects them, and to report any persistent or severe vision problems to their doctor²³.

Choice C is wrong because difficulty urinating or constipation are not adverse effects of carbamazepine, but rather rare side effects that may indicate urinary retention or bowel obstruction¹⁴. The nurse should encourage the client to drink plenty of fluids, eat high-fiber foods, and exercise regularly to prevent these problems, and to report any difficulty passing urine or stool to their doctor³⁴.

Choice D is wrong because nausea or vomiting are not adverse effects of carbamazepine, but rather common side effects that can be minimized by taking the drug with food or milk¹². The nurse should advise the client to eat small, frequent meals and avoid spicy or fatty foo

The nurse should evaluate the response of the client who is receiving gabapentin (Neurontin) for neuropathic pain by measuring the frequency and intensity of pain using a valid and reliable pain scale, such as the numeric rating scale or the visual analog scale¹². The nurse should also ask the client about their satisfaction with pain relief and their functional status²³. The main goal of gabapentin therapy is to reduce pain by at least 50% or to a tolerable level⁴⁵.

Choice B is wrong because increased range of motion and mobility are not outcomes that the nurse should assess the client for when receiving gabapentin for neuropathic pain. Gabapentin is not indicated for musculoskeletal pain or inflammatory pain, and does not have anti-inflammatory or muscle relaxant properties⁶. Gabapentin may improve mobility indirectly by reducing pain, but this is not a direct outcome of the drug.

Choice C is wrong because improved mood and sleep quality are not outcomes that the nurse should assess the client for when receiving gabapentin for neuropathic pain. Gabapentin is not indicated for depression or insomnia, and does not have antidepressant or sedative properties⁶. Gabapentin may improve mood and sleep indirectly by reducing pain, but this is not a direct outcome of the drug.

Choice D is wrong because decreased inflammation and swelling are not outcomes that the nurse should assess the client for when receiving gabapentin for neuropathic pain. Gabapentin is not indicated for inflammatory pain or edema, and does not have anti-inflammatory or diuretic properties⁶. Gabapentin may reduce swelling indirectly by reducing pain, but this is not a direct outcome of the drug.