The patient has epilepsy and receives phenytoin (Dilantin). The patient has been seizure-free, and asks the nurse why he still needs blood tests when he is not having seizures. What is the best response by the nurse?
1. "Because phenytoin (Dilantin) has a very narrow range between a therapeutic dose and a toxic dose."
2. "Because phenytoin (Dilantin) can cause blood-thinning in some patients."
3. "Because phenytoin (Dilantin) can cause Stevens-Johnson syndrome, which will show up in the blood tests."
4. "Because phenytoin (Dilantin) can deplete your system of potassium."
Correct Answer: 1
Rationale: Phenytoin (Dilantin) has a very narrow range between a therapeutic dose and a toxic dose; blood levels must be monitored to ensure a therapeutic level and to prevent toxicity. There isn't any evidence to support that phenytoin (Dilantin) causes potassium depletion. Stevens-Johnson Syndrome is a severe skin reaction that can be an adverse outcome with phenytoin (Dilantin), but it is monitored by skin assessment, not blood tests. Phenytoin (Dilantin) is not an anticoagulant, and does not cause thinning of the blood.
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