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TP is a 48 year old male client admitted to the hospital after having a seizure...

TP is a 48 year old male client admitted to the hospital after having a seizure while attending church. He has a history of seizures and has been taking phenytoin (Dilantin) 100 mg PO TID.

  1. What questions will you want to ask the patient/his family?

On further evaluation, TP admits that he sometimes forgets to take his medication because he feels “so great”. His phenytoin level is 5 mcg/mL.

  1. His wife asks you what that level means. How would you describe his level in regards to the typical therapeutic range?
  1. What education do you need to provide him at this point?

TP is discharged after 3 days with a phenytoin level of 11 mcg/mL. He will be sent home with phenytoin extended release 300mg PO daily. He tells you that part of the reason he is reluctant to take his medication is that when it was originally prescribed, the physician cautioned him that it could easily become toxic in his blood and that he was frightened.

  1. How would you address his concerns? What can be done to minimize the risk of excessive blood levels?
  1. What other education would you provide him regarding his phenytoin therapy? What does he need to watch for? What can he do to minimize the severity of side effects?
  1. What are some general nursing responsibilities regarding care of a patient with seizures?
  1. What if TP was a 24 year old female taking oral contraceptives and prescribed phenytoin? What teaching would she need?

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Expert Solution

Nightingale answered 2 years ago
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