A female patient who takes phenytoin for epilepsy becomes ...

[viki]

A female patient who takes phenytoin for epilepsy becomes pregnant. The nurse will notify the patient's provider and will anticipate that the provider will take which action?
 
  a. Add valproic acid (Depakote) for improved seizure control.
  b. Change the medication to phenobarbital (Luminal).
  c. Closely monitor this patient's serum phenytoin levels.
  d. Discontinue all anticonvulsant medications.

Question 2

The nurse is preparing to administer phenytoin (Dilantin) to a patient who has a seizure disorder. The patient appears drowsy, and the nurse notes that the last random serum drug level was 18 mcg/mL. What action will the nurse take?
 
  a. Administer the dose since the patient is not toxic.
  b. Contact the provider to discuss decreasing the phenytoin dose.
  c. Give the drug and monitor closely for adverse effects.
  d. Report drug toxicity to the providers.

[brittrenee]

Answer to Question 1

ANS: B
Phenytoin has serious teratogenic effects, so women who are pregnant should not take it. Phenobarbital is typically used because possible teratogenic effects are less pronounced. Teratogenicity increases with multiple anticonvulsants.

Answer to Question 2

ANS: A
Drowsiness is a common side effect of phenytoin and is not cause for alarm. The patient's drug level is normal, since 10-20 mcg/mL is the therapeutic range. The nurse should administer the dose. It is not necessary to decrease the dose or monitor the patient more closely than usual.

[viki]

Thanks

[brittrenee]

Welcome