What would the nurse include when creating a teaching plan that includes the long-term administration of phenytoin (Dilantin)?

Choice A reason: Stating that phantom limb pain “does not actually exist” dismisses the client’s experience. Phantom pain is a real neurological phenomenon where the brain perceives pain from the absent limb due to nerve endings at the stump sending signals to the cortex.
Choice B reason: While phantom limb pain is common post-amputation, stating it will “eventually go away” oversimplifies management. Pain may persist due to neuroplastic changes in the sensory cortex, requiring interventions like medications or therapy, and this response does not address immediate needs.
Choice C reason: Offering imagery is a valid pain management strategy, as it can modulate pain perception via cognitive distraction. However, it assumes the pain’s nature without assessing its characteristics, which is critical for tailoring interventions like medications or nerve blocks.
Choice D reason: Asking the client to describe phantom limb pain allows the nurse to assess its quality, intensity, and triggers. This informs targeted interventions, as phantom pain results from nerve sensitization and cortical reorganization, requiring a combination of pharmacological (e.g., gabapentin) and non-pharmacological approaches.

Choice A reason: A visibly shorter leg and extreme pain post-hip arthroplasty suggest possible hip dislocation, a serious complication. Assessing neurovascular status (pulse, sensation, movement, color, temperature) in both legs is critical to detect compromised blood flow or nerve damage, which could lead to tissue ischemia or permanent injury if not addressed promptly.
Choice B reason: Elevating the leg and applying ice may reduce swelling but does not address the potential dislocation indicated by leg shortening and pain. These interventions could delay critical assessment and management of neurovascular compromise, potentially worsening outcomes in a suspected dislocation scenario.
Choice C reason: Administering pain medication may alleviate discomfort but does not address the underlying cause, such as a dislocated hip prosthesis. Pain relief is secondary to ensuring neurovascular integrity and confirming the surgical leg’s alignment, which are critical to prevent complications like tissue necrosis.
Choice D reason: Attempting to place the leg in abduction without confirming the cause of shortening and pain risks further damage, especially if the hip is dislocated. Manipulation could exacerbate neurovascular compromise or prosthesis misalignment, leading to prolonged recovery or additional surgical intervention.