The nurse is assisting in the care of a client being discharged ...

[cagreen833]

The nurse is assisting in the care of a client being discharged on phenytoin (Dilantin), 100 mg 3 times daily, for seizure control.
 
  When providing client teaching about this medication, the nurse should be sure to include which of the following points? Select all that apply. 1. Break the capsules so they are easier to swallow.
  2. Use a soft toothbrush while taking this medication.
  3. If a dose is missed, just wait until the next one is due.
  4. Alcohol should be avoided while taking this medication.
  5. The medication may turn the client's urine pink, red, or brown.
  6. Sore throat is a common side effect of the medication and is nothing to worry about.

Question 2

The nurse has provided discharge instructions to a client being placed on long-term anticoagulant therapy with warfarin (Coumadin). Adequate learning would be evident if the client makes which of the following statements? Select all that apply.
 
  1. I will inform my dentist that I am taking Coumadin.
  2. I may take over-the-counter medications as needed.
  3. I should alternate the timing of my daily dose of Coumadin.
  4. I will have my blood levels checked as prescribed by my physician.
  5. I will report any signs of blood in my urine or stool to my physician.
  6. I should use a firm-bristled toothbrush to prevent the side effects of Coumadin.

[zhanghao]

Answer to Question 1

2, 4, 5

Rationale: Phenytoin is an anticonvulsant that can cause gingival hyperplasia, as well as bleeding, swelling, and tenderness of the gums. The client should use good oral hygiene, gum massage, and have regular dental checkups. Alcohol interferes with the absorption of phenytoin, so it should be avoided. Change in the color of the urine is a normal reaction. A sore throat, fever, glandular swelling, or any skin reaction indicates hematological toxicity and needs to be reported.

Answer to Question 2

1, 4, 5

Rationale: Clients need to notify all health care providers that they are on warfarin (Coumadin) therapy. Dental procedures may put the client at risk for increased bleeding, so this should direct you to I will inform my dentist that I am taking Coumadin. Knowing that the effectiveness of warfarin is based on maintaining a therapeutic blood level will direct you to select I will have my blood levels checked as prescribed by my physician. Awareness of bleeding as a primary complication will direct you to I will report any signs of blood in my urine or stool to my physician.

[cagreen833]

Thanks for the timely response, appreciate it

[kjohnson]

TYSM