Question

PN 200 Fundamentals of Nursing II Grand Mal Seizures - Dilantin SS, a 26-year-old woman, takes phenytoin 100 mg three times a day to control grand mal seizures. SS and her husband are considering starting a family 1. What action should the nurse take in regard to patient family planning? SS complains of frequent "upset stomach" and "bleeding gums" when brushing her teeth. 2. To decrease GI distress, what can the nurse suggest? 3. To alleviate bleeding gums, what patient teaching may be included by the nurse? 4. The nurse checks SS's serum phenytoin level. What are the indications of an abnormal serum level? 5. What appropriate actions should be taken in the event of an abnormal phenytoin level? 6. State the therapeutic phenytoin blood level.

Answer 1

Answer: Nurse should inform the patient that along with the anticonvulsant can cause birth defects. These birth defects includes skeletal abnormalities, urinary tract defects etc. One has to lower the dose while trying for family planning.

To decrease the GI distress, the nurse should suggest the patient to eliminate the fatty food consumption, as well as the medicine should be take with food because on empty stomach this medicine cause irritation and bowel disturbance.

Nurse should suggest the patient that some people may have gum bleeding during the phenytoin medications, so the patient should use soft brush for brushing teeth and massage gums gently.

The normal phenytoin level is 10 and 20 µg/mL, where as if the level is greater than this causes abnormality in the serum level.