A nurse is caring for an 81-year-old patient in a long-term care facility who takes nine different medications each day.
The patient has a recent diagnosis of seizure disorder and has begun treatment with phenytoin (Dilantin), a highly protein-bound drug. After 1 month of Dilantin therapy, the patient is still extremely drowsy and sluggish. The nurse determines that the prolonged adverse effect is likely due to
A) an increase in creatinine to be filtered.
B) polypharmacy decreasing the number of available protein-binding sites.
C) increased efficiency of the bloodbrain barrier.
D) the normally low protein-binding properties of Dilantin.
Question 2
A patient who is experiencing withdrawal from heavy alcohol use have developed psychosis and been treated with haloperidol.
Which of the following assessment findings should prompt the care team to assess the patient for neuroleptic malignant syndrome?
A) The patient demonstrates a significant increase in agitation after being given haloperidol.
B) The patient develops muscle rigidity and a sudden, high fever.
C) The patient complains of intense thirst and produces copious amounts of urine.
D) The patient develops yellowed sclerae and intense pruritis (itchiness).
The general survey includes assessing every patient for signs of distress.
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