A nurse is administering phenytoin to a client. The nurse should monitor for which of the following adverse effects?
Tinnitus
Bleeding gums
Jaundice
Deep vein thrombosis
The Correct Answer is B
A. Tinnitus. Phenytoin is not commonly associated with tinnitus. Ototoxicity is more frequently linked to medications such as aminoglycoside antibiotics, loop diuretics, or high-dose aspirin. While phenytoin affects the nervous system, it does not typically cause ringing in the ears.
B. Bleeding gums. Gingival hyperplasia, characterized by swollen and bleeding gums, is a well-known adverse effect of phenytoin, especially with long-term use. It occurs due to an overgrowth of gum tissue and can be minimized with good oral hygiene and regular dental care. Clients should be advised to brush with a soft-bristled toothbrush and visit the dentist regularly.
C. Jaundice. Although phenytoin is metabolized by the liver, hepatotoxicity and jaundice are not common side effects. However, liver function should still be monitored, particularly in clients with pre-existing liver conditions or those taking other hepatotoxic medications.
D. Deep vein thrombosis. Phenytoin does not significantly increase the risk of deep vein thrombosis (DVT). While some anticonvulsants may affect coagulation factors, phenytoin is not known to cause hypercoagulability or clot formation. Clients at risk for DVT should be monitored for other contributing factors, such as immobility or genetic predisposition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["1"]
Explanation
Convert pounds to kilograms:
Conversion factor: 1 kg = 2.2 lb
=145 lb / 2.2 lb/kg
= 65.9 kg
Calculate the total daily dose:
Total daily dose (mg) = Weight (kg) × Dosage (mg/kg/day)
= 65.9 kg 3 mg/kg/day
= 197.7 mg/day
Calculate the dose per administration (divided into two doses):
Dose per administration (mg) = Total daily dose (mg) / Number of doses
=197.7 mg/day / 2 doses
= 98.85 mg/dose
Calculate the number of tablets per dose:
Number of tablets = Desired dose (mg) / Available dose (mg/tablet)
=98.85 mg/dose / 100 mg/tablet
= 0.9885 tablets
Round to the nearest whole number:
0.9885 tablets is 1 tablet
Correct Answer is C
Explanation
A. Deferoxamine. Deferoxamine is a chelating agent used to treat iron overload or toxicity. It has no role in managing an acute allergic reaction or respiratory distress caused by nafcillin, a penicillin-type antibiotic.
B. Vitamin K. Vitamin K is used to reverse the effects of warfarin-induced anticoagulation and is not indicated for treating an allergic reaction. Anaphylaxis is not related to coagulation disturbances, making this an inappropriate intervention.
C. Epinephrine. Epinephrine is the first-line treatment for anaphylaxis, which can present with difficulty breathing, bronchospasm, and hypotension. It works by stimulating alpha- and beta-adrenergic receptors, leading to bronchodilation, increased cardiac output, and vasoconstriction to counteract severe allergic reactions. Immediate administration is necessary to prevent further airway compromise and circulatory collapse.
D. Prednisone. Prednisone is a corticosteroid used to reduce inflammation and prevent delayed allergic reactions. While it may be prescribed as part of long-term management, it does not provide the rapid bronchodilation and vasoconstriction needed for emergency treatment of anaphylaxis.
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