Which information about a patient who has a new prescription for phenytoin (Dilantin) indicates that the nurse should consult with the health care provider before administration of the medication?

Patient has slight elevations in liver function test results

Patient's most recent blood pressure is 156/92 mm Hg.

Patient experiences an aura before seizures.

Patient has tonic-clonic seizures.

Answer and Explanation

The Correct Answer is A

A. Patient has slight elevations in liver function test results: Phenytoin is primarily metabolized by the liver, and elevated liver function tests may indicate impaired liver function, potentially affecting the metabolism and clearance of phenytoin. Consultation with the healthcare provider is warranted to assess the risk-benefit ratio of administering phenytoin in the presence of liver function abnormalities.

B. Patient's most recent blood pressure is 156/92 mm Hg: While hypertension is not a contraindication for phenytoin administration, it is important to monitor blood pressure, especially considering the potential cardiovascular side effects of the medication. However, elevated blood pressure alone does not typically warrant consultation before administering phenytoin.

C. Patient experiences an aura before seizures: Experiencing an aura before seizures is a common phenomenon in patients with epilepsy and does not necessarily contraindicate the use of phenytoin. In fact, phenytoin is commonly prescribed to prevent seizures, including those preceded by an aura.

D. Patient has tonic-clonic seizures: Phenytoin is indicated for the treatment and prevention of tonic-clonic seizures, among other seizure types. Therefore, the presence of tonic-clonic seizures would not typically warrant consultation before administering phenytoin.

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Correct Answer is B

Explanation

A. Assess for the presence of chest pain: While chest pain should always be assessed in a comprehensive health history and physical examination, it is not specifically related to multiple sclerosis unless there are concurrent cardiac issues.

B. Inquire about urinary tract problems: Urinary symptoms such as urinary urgency, frequency, hesitancy, or incontinence are common in multiple sclerosis due to neurogenic bladder dysfunction. Therefore, it is essential to inquire about these symptoms to assess the extent of neurological involvement and provide appropriate management.

C. Inspect the skin for rashes or discoloration: While skin manifestations can occur in multiple sclerosis, they are less common and not typically primary concerns during initial assessment. However, if the patient reports skin changes, they should be evaluated accordingly.

D. Ask the patient about any increase in libido: Changes in libido are not typically associated with multiple sclerosis unless they are related to psychological or emotional factors. While sexual dysfunction can occur in MS, it is not the primary focus during the initial assessment unless the patient presents with related concerns.

A. The patient had a recent acute myocardial infarction. B. The patient has had migraine headaches for 30 years. C. The patient drinks 1 to 2 cups of coffee daily. D. The patient has taken topiramate (Topamax) for 2 months.

Correct Answer is A

Explanation

A. The patient had a recent acute myocardial infarction: Sumatriptan is contraindicated in patients with a history of myocardial infarction or coronary artery disease due to its vasoconstrictive effects, which could exacerbate ischemia or precipitate cardiovascular events.

B. The patient has had migraine headaches for 30 years: While the duration of migraine headaches is relevant to the patient's history, it is not as immediately concerning as a recent myocardial infarction when considering the use of sumatriptan.

C. The patient drinks 1 to 2 cups of coffee daily: While caffeine consumption may interact with sumatriptan and affect its efficacy or side effects, it is not as immediately concerning as a recent myocardial infarction.

D. The patient has taken topiramate (Topamax) for 2 months: While the use of topiramate may interact with sumatriptan, it is not as immediately concerning as a recent myocardial infarction. However, it is still important to report all medications the patient is taking to the healthcare provider.

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Which information about a patient who has a new prescription for phenytoin (Dilantin) indicates that the nurse should consult with the health care provider before administration of the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What action should the nurse include in completing a health history and physical assessment for a 36-yr-old female patient with possible multiple sclerosis (MS)?

Correct Answer is B

Explanation

The health care provider is considering the use of sumatriptan (Imitrex) for a 54-year-old male patient with migraine headaches. Which information obtained by the nurse is most important to report to the health care provider?

Correct Answer is A

Explanation

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