The nurse is caring for a patient who was given a new medical prescription for phenytoin. What would the nurse stress in the discharge instructions regarding this medication?
"Use a cane or walker when you begin to have difficulty walking."
"Adjust the dose depending upon observed seizure activity."
"You will need to have blood levels drawn annually."
"Be sure to have regular visits to the dentist."
The Correct Answer is D
A. While using a cane or walker may be necessary for some patients experiencing balance issues, it is not a specific instruction related to phenytoin.
B. Phenytoin dosages should not be adjusted solely based on observed seizure activity; the dose must be managed carefully based on serum drug levels and the clinician's guidance.
C. Patients on phenytoin typically require more frequent monitoring of blood levels (every 2-3 months initially) rather than annually, as maintaining therapeutic levels is essential to avoid toxicity or ineffective seizure control.
D. Regular dental visits are crucial for patients taking phenytoin because the medication can cause gingival hyperplasia (overgrowth of gum tissue), which necessitates careful dental hygiene and regular monitoring by a dentist to prevent complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. EEG is a monitoring tool for brain activity, but it is not a prerequisite for ventriculostomy placement.
B. While the procedure is carefully managed to reduce infection risk, ventriculostomy does have an infection risk due to its invasive nature.
C. Ventriculostomy is not inserted via the femoral artery; it is placed directly in the brain’s ventricles.
D. A ventriculostomy is used to monitor ICP and allows for the drainage of cerebrospinal fluid, which helps in managing elevated ICP in patients with brain injuries.
Correct Answer is B
Explanation
A. Scheduled voiding is less effective in patients with a flaccid bladder because there is no voluntary control of bladder function.
B. Intermittent catheterization is the preferred management technique for a flaccid or atonic bladder, allowing the bladder to empty at regular intervals and reducing the risk of infection associated with continuous catheters.
C. An indwelling catheter is usually avoided for long-term use due to a higher risk of infection.
D. An external catheter is generally not effective for flaccid or atonic bladder management in spinal cord injuries as it doesn’t actively empty the bladder.
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