Summary
Summary ( 14 Questions)
The nurse is caring for a client who has been taking phenytoin (Dilantin) for several years to control tonic-clonic seizures. The client tells the nurse that he wants to stop taking the medication because it makes his gums swell and bleed. What is the most appropriate response by the nurse?
Choice A is wrong because the client should not stop taking phenytoin without consulting the provider. Stopping phenytoin suddenly can increase the risk of seizures or status epilepticus, which is a life-threatening condition¹. If the client wants to switch to another anticonvulsant medication, the provider should advise on how to do so safely and gradually¹.
Choice B is wrong because the client should not reduce the dose of phenytoin without consulting the provider. Reducing the dose of phenytoin can lower the blood level of the medication and make it less effective in controlling seizures¹. The provider should monitor the blood level of phenytoin and adjust the dose accordingly¹.
Phenytoin (Dilantin) can cause overgrowth of gum tissue, also known as gingival hyperplasia, in some people¹. This can lead to swelling, bleeding, and infection of the gums¹. Good oral hygiene, such as brushing, flossing, and using mouthwash, can help prevent or reduce gum problems¹. The client should also see the dentist regularly for check-ups and cleaning¹.
Choice D is wrong because the client should not take ibuprofen (Motrin) or aspirin (Ecotrin) to relieve the inflammation and pain in the gums. These medications are nonsteroidal anti-inflammatory drugs (NSAIDs) that can interact with phenytoin and increase its blood level and side effects². They can also increase the risk of bleeding, especially in people with low platelet count or clotting problems². The client should consult the provider before taking any other medications with phenytoin¹.
Phenytoin (Dilantin) can cause overgrowth of gum tissue, also known as gingival hyperplasia, in some people¹. This can lead to swelling, bleeding, and infection of the gums¹. Good oral hygiene, such as brushing, flossing, and using mouthwash, can help prevent or reduce gum problems¹. The client should also see the dentist regularly for check-ups and cleaning¹.
Choice A is wrong because the client should not stop taking phenytoin without consulting the provider. Stopping phenytoin suddenly can increase the risk of seizures or status epilepticus, which is a life-threatening condition¹. If the client wants to switch to another anticonvulsant medication, the provider should advise on how to do so safely and gradually¹.
Choice B is wrong because the client should not reduce the dose of phenytoin without consulting the provider. Reducing the dose of phenytoin can lower the blood level of the medication and make it less effective in controlling seizures¹. The provider should monitor the blood level of phenytoin and adjust the dose accordingly¹.
Choice D is wrong because the client should not take ibuprofen (Motrin) or aspirin (Ecotrin) to relieve the inflammation and pain in the gums. These medications are nonsteroidal anti-inflammatory drugs (NSAIDs) that can interact with phenytoin and increase its blood level and side effects². They can also increase the risk of bleeding, especially in people with low platelet count or clotting problems². The client should consult the provider before taking any other medications with phenytoin¹.