A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching?

"I'll be glad when I can stop taking this medicine."

"I have made an appointment to see my dentist next week."

"I will notify my doctor before taking any other medications."

"I know that I cannot switch brands of this medication."

Answer and Explanation

The Correct Answer is A

Phenytoin is an anticonvulsant medication that is used to prevent and treat seizures. It works by stabilizing the electrical activity of the brain and reducing the spread of abnormal impulses. Phenytoin is usually taken for life or until the seizures are controlled by other means, such as surgery or diet. The client should not stop taking phenytoin without consulting their doctor, as this can cause withdrawal symptoms or increase the risk of seizures.

The other options are correct and indicate that the client understands the discharge teaching because:

"I have made an appointment to see my dentist next week." This statement is correct because phenytoin can cause gingival hyperplasia, which is an overgrowth of gum tissue that can lead to bleeding, infection, or difficulty chewing. The client should practice good oral hygiene and see their dentist regularly to prevent or treat this condition.

"I will notify my doctor before taking any other medications." This statement is correct because phenytoin can interact with many other medications, such as antibiotics, anticoagulants, oral contraceptives, or antacids. These interactions can aﬀect the blood levels and eﬀectiveness of phenytoin or the other medications, causing adverse eﬀects or reduced seizure control. The client should inform their doctor of any other medications they are taking or planning to take, including over-the-counter, herbal, or dietary supplements.
"I know that I cannot switch brands of this medication." This statement is correct because diﬀerent brands of phenytoin may have diﬀerent formulations or bioavailability, which can aﬀect the absorption and metabolism of the drug. Switching brands can cause changes in the blood levels and eﬀectiveness of phenytoin, leading to toxicity or reduced seizure control. The client should always use the same brand of phenytoin and check with their pharmacist if they notice any changes in the appearance or labeling of their medication.

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Correct Answer is D

Explanation

Moving objects away from the client is an important action to take during a seizure, as it can prevent injury and protect the client from harm.

"Place the client on his back." is not correct, as it can cause airway obstruction and aspiration. The client should be placed on his side, preferably in a lateral recumbent position, to allow saliva and secretions to drain from the mouth.

"Restrain the client." is not appropriate, as it can cause injury, increase agitation, or prolong the seizure. The client should be allowed to move freely during a seizure, but supported and guided away from hazards.

"Insert a padded tongue blade into the client's mouth." is not advisable, as it can cause oral trauma, choking, or damage to the teeth. The client should not have anything inserted into his mouth during a seizure, as he cannot swallow or bite his tongue. The nurse should ensure that the client's airway is clear and patent.

A. Place a moist heating pad under the client's feet. B. Increase the client's oral ﬂuid intake. C. Obtain a pair of slipper-socks for the client. D. Rub the client's feet briskly for several minutes.

Correct Answer is C

Explanation

Obtaining a pair of slipper socks for the client is a simple and safe way to provide warmth and insulation to the feet, which can improve blood ﬂow and comfort.

Placing a moist heating pad under the client's feet is not recommended, as it can cause burns, vasodilation, or increased ﬂuid loss, which can worsen the condition.

Increasing the client's oral ﬂuid intake is not relevant, as it does not aﬀect the temperature or circulation of the feet.

Rubbing the client's feet briskly for several minutes is not advisable, as it can cause trauma, inﬂammation, or ulceration to the fragile skin and tissues of the feet.

Obtaining a pair of slipper socks for the client is a simple and safe way to provide warmth and insulation to the feet, which can improve blood ﬂow and comfort.

Placing a moist heating pad under the client's feet is not recommended, as it can cause burns, vasodilation, or increased ﬂuid loss, which can worsen the condition.

Increasing the client's oral ﬂuid intake is not relevant, as it does not aﬀect the temperature or circulation of the feet.

Rubbing the client's feet briskly for several minutes is not advisable, as it can cause trauma, inﬂammation, or ulceration to the fragile skin and tissues of the feet.

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A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching?

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