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?

Planning to lower saturated fats to 10 percent of the daily calorie intake is a good dietary recommendation for a client who has hypertension, as it can help lower cholesterol, prevent atherosclerosis, and reduce the risk of cardiovascular complications.

a. "Limit your alcohol consumption to three drinks a day." is not correct, as it is too high for a client who has hypertension. The client should limit alcohol consumption to no more than one drink a day for women and two drinks a day for men, as alcohol can increase blood pressure and interfere with medication effectiveness.

c. "Diuretics are the first type of medication to control hypertension." is not accurate, as diuretics are not always the first choice of medication for hypertension. The choice of medication depends on the client's individual factors, such as age, race, comorbidities, and contraindications. Diuretics are one of the classes of antihypertensive drugs that can be used alone or in combination with other drugs.

d. "Reaching your goal blood pressure will occur within 2 months." is not realistic, as reaching the goal blood pressure may take longer than 2 months, depending on the client's baseline blood pressure, response to treatment, adherence to lifestyle modifications, and presence of other conditions. The client should monitor his blood pressure regularly and follow up with the provider as needed.

Nitroglycerin is a vasodilator that relaxes smooth muscle in blood vessels and reduces myocardial oxygen demand. It is used to treat and prevent angina atacks. A common side effect of nitroglycerin is headache, which is caused by cerebral vasodilation. The nurse should advise the client to take a mild analgesic, such as acetaminophen, to relieve the headache. The headache usually subsides with continued use of nitroglycerin.

The other options are not correct because:

"Take only one dose of nitroglycerin to reduce the risk of getting a headache." This statement is incorrect because it may compromise the effectiveness of nitroglycerin in relieving angina. The client should follow the prescribed dosage and frequency of nitroglycerin, which is usually one tablet every 5 minutes for up to three doses, as needed for chest pain.

"There's nothing that can be done to relieve the headaches that nitroglycerin causes." This statement is incorrect because it is discouraging and dismissive of the client's concern. The nurse should acknowledge the client's

discomfort and offer suggestions for managing the side effect, such as taking a mild analgesic or lying down in a dark room.

"We will ask the provider to prescribe a different medication for you." This statement is incorrect because it implies that nitroglycerin is not suitable for the client and may cause unnecessary anxiety or confusion. The nurse should explain that nitroglycerin is an effective and safe medication for angina and that the headache is a common and transient side effect that can be managed with simple measures. The nurse should also inform the client that there are other forms of nitroglycerin, such as patches or sprays, that may have less headache-inducing effects. However, changing the medication or the route of administration should be done only after consulting with the provider.