A nurse is reviewing the medication history of a client who has epilepsy and is taking valproic acid. The nurse notes that the client is also taking warfarin for atrial fibrillation. What is the most appropriate action for the nurse to take?

This means that the drug has leaked out of the vein and into the surrounding tissue, causing inflammation, pain, and tissue damage⁵⁶. Phenytoin is a known vesicant, which means it can cause severe skin reactions when extravasated⁵. The clinical manifestation of phenytoin extravasation is called purple glove syndrome (PGS), which is characterized by a purplish to black discoloration of the extremity followed by peripheral edema and pain distal to the site of infusion¹².

Choice A is wrong because the client is not having an allergic reaction to phenytoin. An allergic reaction would cause symptoms such as rash, itching, hives, swelling of the face or throat, difficulty breathing, or anaphylaxis⁷. The client's symptoms are localized to the hand and are consistent with extravasation, not allergy.

Choice B is wrong because the client is not developing purple glove syndrome. Purple glove syndrome is the name of the condition caused by phenytoin extravasation, not a separate entity¹². The client already has purple glove syndrome as a result of the extravasation.

Choice D is wrong because the client is not developing thrombophlebitis. Thrombophlebitis is inflammation of a vein caused by a blood clot, usually in the legs⁸⁹. Thrombophlebitis can cause symptoms such as