A patient with Parkinson's disease asks the nurse why anticholinergics are used in the treatment. Which response by the nurse is most accurate?

A. Polyuria:

Polyuria, or increased urine output, is not typically associated with increased intracranial pressure. It may occur due to other factors such as diabetes insipidus or fluid administration.

B. Battle's sign:

Battle's sign refers to bruising behind the ear and is often associated with basilar skull fractures. While it can indicate a head injury, it is not a direct manifestation of increased intracranial pressure.

C. Nuchal rigidity:

Nuchal rigidity, stiffness of the neck muscles, is commonly associated with meningitis rather than increased intracranial pressure. It is a sign of meningeal irritation and inflammation rather than direct pressure within the skull.

D. Lethargy:

This is the correct answer. Lethargy, or excessive drowsiness or fatigue, can be an early manifestation of increased intracranial pressure. As pressure increases within the skull, it can lead to alterations in consciousness ranging from lethargy to coma. Monitoring the client for changes in level of consciousness, including lethargy, is important for early detection of increased intracranial pressure.

A. "I will notify my provider before taking any other medications."

This statement demonstrates understanding of the importance of consulting the provider before taking any other medications. It is correct because phenytoin may interact with other drugs, so notifying the provider is essential to avoid potential interactions.

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

This statement indicates that the client understands the importance of dental care while taking phenytoin. Phenytoin can cause gum overgrowth (gingival hyperplasia), so regular dental check-ups are recommended to monitor oral health. This statement is correct.

C. "I will take this medication with meals."

This statement suggests that the client plans to take phenytoin with meals. However, phenytoin should generally be taken on an empty stomach to enhance absorption, unless gastrointestinal upset occurs. Therefore, this statement indicates a need for further teaching.

D. "I'll be glad when my seizures stop so I can quit taking this medicine."

This statement reflects a misconception about the management of epilepsy. Phenytoin is typically used as a long-term treatment to prevent seizures, not as a short-term solution to stop seizures. Therefore, this statement indicates a need for further education about the chronic nature of epilepsy and the need for ongoing medication adherence.

E. “I’ll take this medication before meals.”

This statement correctly indicates the timing of phenytoin administration before meals. Taking phenytoin before meals helps enhance absorption and minimize the risk of gastrointestinal side effects. Therefore, this statement is correct.