Which information about a 72-year-old patient who has a new prescription for phenytoin (Dilantin) indicates that the nurse should consult with the health care provider before administration of the medication?
a. Patient has generalized tonic-clonic seizures.
b. Patient experiences an aura before seizures.
c. Patient's most recent blood pressure is 156/92 mm Hg.
d. Patient has minor elevations in the liver function tests.
ANS: D
Many older patients (especially with compromised liver function) may not be able to metabolize phenytoin. The health care provider may need to choose another antiseizure medication. Phenytoin is an appropriate medication for patients with tonic-clonic seizures, with or without an aura. Hypertension is not a contraindication for phenytoin therapy.
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