A nurse is teaching a client newly diagnosed with a seizure disorder about phenytoin sodium therapy. What information should the nurse stress regarding the client stopping the drug suddenly? The drug should not be stopped abruptly because:

A) "I agree. Sometimes the adverse effects can be worse than the disease":
While it's important for the nurse to acknowledge the client's concerns, making this statement may not be helpful in this situation. It could unintentionally reinforce fear and anxiety, implying that the chemotherapy's side effects may be worse than the disease itself, which is not always the case. Instead, the nurse should engage the client in a discussion to explore the specific concerns, allowing for tailored support and information.

B) "Someone from the American Cancer Society will be here soon to answer your questions":
While the American Cancer Society can provide valuable support and resources, referring the client to someone else to answer their questions can feel dismissive. The nurse should take the opportunity to listen to the client’s concerns and provide immediate reassurance or information. Direct involvement in the discussion builds trust and allows for more immediate emotional and psychological support.

C) "What is it about the adverse effects that concern you?":
This response is the most appropriate as it encourages the client to express their specific concerns. By asking the client to clarify their worries, the nurse can provide more accurate information, address misunderstandings, and offer reassurance. This open-ended question helps the nurse understand the client's emotions and individual needs, which allows for a more personalized approach in managing anxiety and providing education about the chemotherapy treatment.
D) "I will have your provider discuss the adverse effects with you before the treatment begins":
While it is important for the healthcare provider to discuss the treatment plan and potential side effects, the nurse should not defer the conversation entirely. The nurse plays an essential role in providing ongoing support, educating the client, and answering questions. The nurse can start the conversation and provide information about the common side effects of chemotherapy, offering the opportunity for further discussion with the provider as needed. Deferring the conversation might leave the client feeling unsupported.

A) Clubbing of the fingers
Clubbing of the fingers is typically associated with chronic hypoxia, often due to conditions like chronic obstructive pulmonary disease (COPD), congenital heart defects, or chronic respiratory disorders. While mitral valve stenosis can lead to pulmonary congestion and sometimes hypoxia, clubbing is not a hallmark finding of mitral valve stenosis.

B) A heart murmur
Mitral valve stenosis is commonly characterized by a heart murmur. The stenosis (narrowing) of the mitral valve obstructs blood flow from the left atrium to the left ventricle, leading to turbulent blood flow. This creates a characteristic diastolic murmur (a low-pitched, rumbling murmur heard best at the apex of the heart with the patient in the left lateral decubitus position).

C) Barrel chest
A barrel chest is more commonly associated with chronic obstructive pulmonary disease (COPD), emphysema, and other conditions that cause long-term hyperinflation of the lungs. It is not a typical finding in mitral valve stenosis. The shape of the chest may change over time in patients with severe left-sided heart failure, but this is not a primary or direct consequence of mitral valve stenosis.

D) Bradycardia
Bradycardia (a slow heart rate) is not a characteristic finding of mitral valve stenosis. In fact, mitral valve stenosis can lead to increased heart rates due to reduced cardiac output and compensatory mechanisms. As the left atrium becomes increasingly distended from the obstruction, atrial fibrillation (a rapid, irregular heartbeat) is common in mitral valve stenosis.