Author Question: A patient has taken phenytoin (Dilantin) for 2 months. The patient is concerned about the different ... (Read 81 times)

jhjkgdfhk · **on:** Jul 23, 2018

A patient has taken phenytoin (Dilantin) for 2 months. The patient is concerned about the different appearance of the capsules in the most recent prescription. The nurse verifies the label and dosage.

What instructions should the nurse provide to the patient?
a. Discard the medication and obtain a new prescription.
b. The prescription is correct. The appearance may be different if a different pharmaceutical company produced the capsules, although the effectiveness would not be altered.
c. You should consistently receive the same formulation to maintain a constant blood level.
d. Take the medication back to the pharmacy where you got it filled and alert the pharmacist.

Question 2

A nurse is completing a discharge plan for a 24-year-old woman who has been prescribed an antiepileptic drug. What is the priority for teaching the patient about this drug?

a. If you stop taking the medication all of a sudden, an unpleasant, acute withdrawal syndrome is likely to occur.
b. You may stop taking this drug when you have had no seizures for 1 full year.
c. Let's talk about what kind of contraception you plan to use while you are taking this medication.
d. I know it's depressing to have to take a drug for the rest of your life, but you absolutely may not ever stop taking it.

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

Answer to Question 1

ANS: B
Phenytoin is available in four oral formulations, and the color and size of the capsules may vary.
The medication should not be discarded once the nurse verifies the label and dosage.
Constant blood levels are maintained by accurate dosing, not formulation.
Taking the medication back to the pharmacy is not necessary, because the nurse has verified that it is the correct medication.

Answer to Question 2

ANS: C
Because antiepilepsy drugs can harm the fetus, managing epilepsy during pregnancy is a challenge. It is most appropriate for the patient to understand the risks involved, and she should be counseled about the use of contraceptives, which may also have drug-to-drug interactions with the antiepilepsy drugs.
It is important for the patient to understand that withdrawal may occur if the drug is discontinued abruptly; however, because this patient is of childbearing age, the risk of pregnancy is higher.
The decision to discontinue seizure medication should be made on an individual basis and by the prescriber. The nurse should not advise the patient to discontinue use after a year of being seizure free.
Telling the patient that she may never come off the medication is not something that can be foreseen.