Which condition would indicate to the nurse that the patient has a phenytoin (Dilantin) toxicity?

Nystagmus

Strabismus

Blurry vision

Amblyopia

Answer and Explanation

The Correct Answer is A

A. Nystagmus:

Nystagmus is an involuntary, rhythmic movement of the eyes, which can be rapid and jerky. It is a common neurological manifestation of phenytoin toxicity. Patients experiencing phenytoin toxicity may exhibit horizontal or vertical nystagmus, which can be detected upon physical examination.

B. Strabismus:

Strabismus, also known as crossed eyes or squint, refers to a misalignment of the eyes. While strabismus can have various causes, it is not typically associated with phenytoin toxicity. Therefore, it is less likely to indicate phenytoin toxicity compared to nystagmus.

C. Blurry vision:

Blurry vision, or visual disturbances, can occur in patients experiencing phenytoin toxicity. However, it is a non-specific symptom and can be observed in various other conditions as well. Patients with phenytoin toxicity may experience blurry vision, double vision (diplopia), or other visual disturbances due to the effects of the medication on the central nervous system.

D. Amblyopia:

Amblyopia, also known as lazy eye, is a condition characterized by reduced vision in one or both eyes. It is typically associated with visual development during childhood and is not directly related to phenytoin toxicity. Therefore, it is less likely to indicate phenytoin toxicity compared to nystagmus or other neurological manifestations.

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Correct Answer is C

Explanation

A. Hyperglycemia:

Hyperglycemia refers to high blood sugar levels. While certain medications can affect glucose metabolism and potentially lead to hyperglycemia as a side effect, this is not typically associated with hydantoin therapy for seizure disorder. Therefore, it is less likely for the patient to experience hyperglycemia as a direct result of taking hydantoin medication.

B. Hunger:

Hunger is not a common side effect of hydantoin therapy for seizure disorder. While some medications may affect appetite or cause changes in eating habits, hunger is not a typical side effect of hydantoin medications such as phenytoin.

C. Hypoglycemia:

Hypoglycemia refers to low blood sugar levels, which can lead to symptoms such as confusion, dizziness, sweating, and weakness. Hydantoin medications, particularly phenytoin, can affect glucose metabolism and increase the risk of hypoglycemia, especially in patients who already have diabetes or are prone to low blood sugar. Therefore, it is important for patients taking hydantoin therapy to monitor their blood sugar levels regularly and be aware of the signs and symptoms of hypoglycemia.

D. Pupil dilation:

Pupil dilation, or mydriasis, is not a common side effect of hydantoin therapy for seizure disorder. While certain medications may affect pupil size, this is not typically associated with hydantoin medications such as phenytoin.

A. Fresh fish B. Cheddar cheese C. Cherries D. Chicken

Correct Answer is B

Explanation

A. Fresh fish

Fresh fish does not contain significant amounts of tyramine. Therefore, there is no need to eliminate fresh fish from the client's diet due to its interaction with selegiline.

B. Cheddar cheese

This is the correct answer. Cheddar cheese is a high-tyramine food and should be eliminated from the client's diet when taking MAOIs. Aged cheeses, such as cheddar, contain high levels of tyramine due to the fermentation process, which can increase the risk of a hypertensive crisis when combined with MAOIs.

C. Cherries

Cherries do not contain significant amounts of tyramine. Therefore, there is no need to eliminate cherries from the client's diet due to their interaction with selegiline.

D. Chicken

Chicken does not contain significant amounts of tyramine. Therefore, there is no need to eliminate chicken from the client's diet due to its interaction with selegiline.

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Which condition would indicate to the nurse that the patient has a phenytoin (Dilantin) toxicity?

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