Author Question: The patient has epilepsy and receives phenytoin (Dilantin). The patient has been seizure-free, and ... (Read 94 times)

mcmcdaniel · **on:** Jul 23, 2018

The patient has epilepsy and receives phenytoin (Dilantin). The patient has been seizure-free, and asks the nurse why he still needs blood tests when he is not having seizures. What is the best response by the nurse?

1. Because phenytoin (Dilantin) has a very narrow range between a therapeutic dose and a toxic dose.
2. Because phenytoin (Dilantin) can cause blood-thinning in some patients.
3. Because phenytoin (Dilantin) can cause Stevens-Johnson syndrome, which will show up in the blood tests.
4. Because phenytoin (Dilantin) can deplete your system of potassium.

Question 2

The nurse has been conducting medication education for a patient with epilepsy. What is the best outcome for this patient?

1. The patient will recognize that the antiseizure medication must be continued indefinitely.
2. The patient will recognize the need to be on a tyramine-free diet while on antiseizure medications.
3. The patient will recognize the need to be on a ketogenic diet in combination with antiseizure medications.
4. The patient will recognize the need to be on antiseizure medication for one year after the last seizure.

courtney_bruh · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 1
Rationale: Phenytoin (Dilantin) has a very narrow range between a therapeutic dose and a toxic dose; blood levels must be monitored to ensure a therapeutic level and to prevent toxicity. There isn't any evidence to support that phenytoin (Dilantin) causes potassium depletion. Stevens-Johnson Syndrome is a severe skin reaction that can be an adverse outcome with phenytoin (Dilantin), but it is monitored by skin assessment, not blood tests. Phenytoin (Dilantin) is not an anticoagulant, and does not cause thinning of the blood.

Answer to Question 2

Correct Answer: 1
Rationale: Once seizures have been controlled, patients are continued indefinitely on the antiseizure drug. In general, withdrawal of antiseizure drugs should only be attempted after at least 3 years of being seizure free. A ketogenic diet is indicated when seizures cannot be controlled through pharmacotherapy or when there are unacceptable side effects to the medications. A tyramine-free diet is indicated for patients receiving monoamine oxidase inhibitor medications.