A nurse counsels a patient who is to begin taking phenytoin [Dilantin] for epilepsy. Which statement by the patient indicates understanding of the teaching?
a. "I should brush and floss my teeth regu-larly."
b. "Once therapeutic blood levels are reached, they are easy to maintain."
c. "I can consume alcohol in moderation while taking this drug."
d. "Rashes are a common side effect but are not serious."
A
Gingival hyperplasia occurs in about 20% of patients who take phenytoin. It can be minimized with good oral hygiene, so patients should be encouraged to brush and floss regularly. Because small fluctuations in phenytoin levels can affect response, maintaining therapeutic levels is not easy. Patients should be cautioned against consuming alcohol while taking phenytoin. Rashes can be serious and should be reported immediately.
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