The client tells the nurse that she has been prescribed phenytoin (Dilantin) for 2 years and is still having too many side effects. She wants to stop taking it. What is the best response by the nurse?
1. "This is the best medication for you; we can add another medication to decrease the side effects associated with phenytoin (Dilantin)."
2. "Please do not stop the medication abruptly, as you will have withdrawal seizures."
3. "You have probably been on the medication long enough; I'll let your doctor know you are stopping it."
4. "Side effects are a problem, but they are not as bad as the seizures you were having."
Correct Answer: 2
Rationale 1: There is no other medication that can be added to decrease the side effects associated with phenytoin (Dilantin).
Rationale 2: Seizures are likely to occur with abrupt withdrawal of antiseizure medication. The medication must be withdrawn over a period of 6–12 weeks.
Rationale 3: The nurse does not know if the client has been on the medication long enough, and the client must be informed of the consequences of abruptly stopping the medication.
Rationale 4: Telling a client that medication side effects are not as bad as seizures is an inappropriate and nontherapeutic response that does not address the client's concerns.
Global Rationale: Seizures are likely to occur with abrupt withdrawal of antiseizure medication. The medication must be withdrawn over a period of 6–12 weeks. There is no other medication that can be added to decrease the side effects associated with phenytoin (Dilantin). The nurse does not know if the client has been on the medication long enough, and the client must be informed of the consequences of abruptly stopping the medication. Telling a client that medication side effects are not as bad as seizures is an inappropriate and nontherapeutic response that does not address the client's concerns.
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