Pharmacological and Parenteral Therapies Q 101

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A patient recently started on phenytoin (Dilantin) to control simple complex seizures is seen in the outpatient clinic. Which information obtained during his chart review and assessment will be of greatest concern?

  

     A. The gums appear enlarged and inflamed.

     B. The white blood cell count is 2300/mm3.

     C. Patient occasionally forgets to take the phenytoin until after lunch.

     D. Patient wants to renew his driver’s license next month.

    

    

Correct Answer: B. The white blood cell count is 2300/mm3.

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Leukopenia is a serious adverse effect of phenytoin and would require discontinuation of the medication.

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Option A: Inflammation of the gums should be reported to the physician, but it does not require immediate attention.

Option C: The nurse should include in the patient teaching the importance of taking medications on time to avoid episodes of seizure.

Option D: Driving is prohibited for a client with a seizure disorder. This should be included in the patient’s teaching, but will not require a change in medical treatment for the seizures.

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