The nurse is completing discharge teaching to a patient following ...

[asmith134]

The nurse is completing discharge teaching to a patient following hospitalization for a seizure disorder who is being prescribed phenytoin (Dilantin). What should the nurse include in these instructions?
 
  1. Maintain good oral hygiene, use a soft toothbrush, massage the gums, and floss daily.
  2. Carry identification indicating the type of seizures for which you are being treated.
  3. You will need to have your sodium level monitored.
  4. If you skip a dose, make sure you double the dose the next day.

Question 2

The nurse is caring for a patient in the postoperative unit following carotid endarterectomy. How should the nurse position the patient?
 
  1. On the unoperated side, either in a flat position or with the head of the bed elevated 30 degrees.
  2. On the operated side with the head of the bed in semi-Fowler's position.
  3. On the unoperated side with a small towel placed directly against the operative site.
  4. On the operated side with a pressure dressing over the operative site.

[Ashley I]

Answer to Question 1

Correct Answer: 1
Phenytoin causes gingival hyperplasia, which results in soft, enlarged gums that are prone to bleeding. Oral hygiene using a soft toothbrush, massaging the gums, flossing daily, and scheduling regular dental checkups are included in discharge teaching. Carrying identification about the seizure disorder is important but not specific to the patient on phenytoin. Liver function studies and serum calcium levels should be monitored to avoid liver problems and bone demineralization, which are characteristic of phenytoin. Blood levels of antiseizure drugs should be maintained so taking the exact dosage as prescribed is important. Patients should not alter the daily dose without discussing this with their primary care provider.

Answer to Question 2

Correct Answer: 1
Position the patient on the unoperated side and either maintain a flat position or elevate the head of the bed 30 degrees as prescribed. Pressure on the wound is undesirable.