The physician has prescribed phenytoin (Dilantin) for a client with diabetes mellitus, type
1. What does the nurse include in the plan of care for this client?
1. Plan to institute safety precautions, as the client is at risk for dizziness and ataxia.
2. Plan to discuss with the physician the need to increase the client's insulin based on serum glucose levels.
3. Plan to assess the client for petechiae, epistaxis, and hematuria.
4. Plan to discuss with the physician the need to decrease the client's insulin based on serum glucose levels.
2. Plan to discuss with the physician the need to increase the client's insulin based on serum glucose levels.
Rationale:
Phenytoin (Dilantin) can increase serum glucose levels, and the client may need additional insulin. All clients receiving phenytoin (Dilantin) are at risk for dizziness and ataxia; this is not specific to the client with diabetes mellitus, type 1. All clients receiving phenytoin (Dilantin) are at risk for petechiae, epistaxis, and hematuria; this is not specific to the client with diabetes mellitus, type 1. Phenytoin (Dilantin) can increase serum glucose levels, not decrease them.
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