A nurse is reinforcing teaching with a female client who is taking phenytoin. Which of the following statements should the nurse include in the teaching?
"You should expect to have blood work every 6 months while taking this medication."
*You can safely take this medication if you become pregnant."
"You might experience swollen gums while taking this medication."
"You can skip a dose of this medication if you are nauseated."
The Correct Answer is C
A) "You should expect to have blood work every 6 months while taking this medication.": While it is important for clients on phenytoin to have regular blood work, especially to monitor drug levels and assess for potential side effects (e.g., liver function, complete blood count), the frequency of blood work is typically more frequent than every 6 months. Blood work is often performed at least every 3-6 months, or more frequently if there are concerns about phenytoin levels or side effects. Therefore, this statement is not accurate.
B) "You can safely take this medication if you become pregnant.": Phenytoin is classified as a Category D medication in pregnancy, meaning it has been shown to cause potential harm to the fetus. It is not considered safe during pregnancy, and women who are pregnant or planning to become pregnant should discuss alternative medications with their healthcare provider.
C) "You might experience swollen gums while taking this medication.": Gingival hyperplasia (swelling of the gums) is a common side effect of phenytoin. Clients taking this medication should be aware of this potential side effect and should be instructed on proper oral hygiene and regular dental checkups to help minimize this risk. This statement is accurate and should be included in the teaching.
D) "You can skip a dose of this medication if you are nauseated.": It is important not to skip doses of phenytoin, as maintaining therapeutic levels of the drug is crucial for its effectiveness in preventing seizures. If a client experiences nausea or difficulty taking the medication, they should contact their healthcare provider for guidance rather than skipping doses. Skipping doses could lead to breakthrough seizures.
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Related Questions
Correct Answer is C
Explanation
A) "I get nervous when I'm in a large group": This statement indicates social anxiety or discomfort, which is common among adolescents. While it may affect the client's well-being, it does not suggest an immediate risk for suicide.
B) "My partner and I had our first argument last night": While relationship issues can cause stress, this statement by itself does not indicate suicidal ideation. Arguments in relationships are a normal part of adolescent development and are not typically associated with a suicide risk unless other risk factors are present.
C) "I am not interested in anything anymore.": This is a concerning statement, as it suggests anhedonia, a hallmark symptom of depression. A lack of interest in activities once enjoyed, especially in adolescents, can be a significant risk factor for suicide and warrants further evaluation and intervention.
D) "I'm not sleeping much because of all the homework I have.": Although sleep disturbances can be a sign of stress, especially related to academic pressure, this is not an immediate indication of suicidal thoughts. Sleep issues can often be managed with lifestyle changes or stress management techniques.
Correct Answer is B
Explanation
A) Medical health insurance claims:
Medical health insurance claims are not relevant to the referral for physical therapy. This information is typically handled by billing departments and insurance providers. The focus of a physical therapy referral is on the patient's clinical condition and needs, not their insurance coverage.
B) Physical assessment findings:
This is the most relevant information to include in a referral for physical therapy. The physical assessment findings provide the physical therapist with important details about the client's mobility, strength, range of motion, and other factors that can guide the creation of an individualized therapy plan. These findings help the therapist understand the client's current physical capabilities and limitations.
C) Medications taken prior to admission:
While it is important for the healthcare team to be aware of the medications a client is taking, this information is not as crucial for the physical therapy referral itself. The physical therapist may need to know about medications if they have a direct impact on the client's physical functioning (e.g., sedatives or pain medications), but the primary focus for the referral would be on the physical assessment findings.
D) Family medical history:
Family medical history is typically relevant to a broader health assessment but is not generally included in a referral for physical therapy. The therapist will be more concerned with the client's current physical condition and functional abilities rather than the medical history of the client's family.
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