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 The medication must be withdrawn over a period of 6 to 12 weeks.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 The medication must be withdrawn over a period of 6 to 12 weeks.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