Hydantoin Review Nursing Process Quiz
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Questions and Answers

What is the primary mechanism of action of phenytoin?

  • Inhibiting sodium influx, stabilizing cell membranes, and reducing repetitive neuronal firing (correct)
  • Inhibiting the reuptake of neurotransmitters
  • Activating the gamma-aminobutyric acid (GABA) receptor
  • Blocking the N-methyl-D-aspartate (NMDA) receptor
  • What is a common side effect of phenytoin that can be prevented with diligent oral hygiene?

  • Leukopenia
  • Hyperglycemia
  • Thrombocytopenia
  • Gingival hyperplasia (correct)
  • What is a contraindication for phenytoin therapy?

  • Pregnancy
  • Diabetes
  • Thyroid disease
  • All of the above (correct)
  • What is a laboratory test that should be monitored in patients taking phenytoin?

    <p>All of the above</p> Signup and view all the answers

    What is a critical instruction that should be given to patients taking phenytoin?

    <p>Take the medication at the same time daily</p> Signup and view all the answers

    What is a potential long-term effect of phenytoin therapy?

    <p>Gingival hyperplasia</p> Signup and view all the answers

    What is a serious side effect of phenytoin that requires immediate medical attention?

    <p>Stevens-Johnson Syndrome</p> Signup and view all the answers

    What is an important instruction for patients taking phenytoin who are planning to travel?

    <p>Plan for routine appointments and lab monitoring while traveling</p> Signup and view all the answers

    Match the following side effects with the medication phenytoin:

    <p>Thrombocytopenia = Bleeding and bruising risk Leukopenia = Infection prevention Gingival hyperplasia = Diligent oral hygiene Stevens-Johnson Syndrome = Report changes in skin</p> Signup and view all the answers

    Match the following symptoms with signs of phenytoin toxicity:

    <p>Increased sedation = Signs of toxicity Nystagmus = Signs of toxicity Tremors = Signs of toxicity Vision Changes = Signs of toxicity</p> Signup and view all the answers

    Match the following cautions with patient conditions for phenytoin therapy:

    <p>Thyroid disease = Cautions Diabetes = Cautions Cardiac disease = Cautions Renal and liver disease = Cautions</p> Signup and view all the answers

    Match the following symptoms with potential psychological effects of phenytoin:

    <p>Tinnitus = Mood and behavior changes Suicidal Ideation = Mood and behavior changes Ataxia = Mood and behavior changes Fatigue = Mood and behavior changes</p> Signup and view all the answers

    Match the following instructions with patient teaching for phenytoin therapy:

    <p>Diligent oral hygiene (soft bristle toothbrush) = Patient Teaching Do not discontinue abruptly = Patient Teaching Monitor and report changes in BP and HR = Patient Teaching Medical Alert Bracelet = Patient Teaching</p> Signup and view all the answers

    Match the following symptoms with their corresponding effects on the body due to phenytoin:

    <p>GI Upset = Body effect Urine Discoloration = Body effect BP/HR Changes = Body effect Liver/Renal impairment = Body effect</p> Signup and view all the answers

    Match the following precautions with actions for patients taking phenytoin:

    <p>Avoid ETOH or other CNS depressants = Precautions Monitor for bleeding and bruising = Precautions Pregnancy prevention = Precautions Plan for travel to ensure you have enough medication = Precautions</p> Signup and view all the answers

    Match the following surveillance tasks with recommendations for phenytoin therapy:

    <p>Monitor Serum values &amp; CBC = Surveillance tasks Monitor for Toxicity = Surveillance tasks Anticipate lab monitoring, routine appointments and vitamin supplementation = Surveillance tasks Report changes in skin = Surveillance tasks</p> Signup and view all the answers

    Match the following laboratory tests with their corresponding purposes in patients taking phenytoin:

    <p>Serum values = Monitor for toxicity CBC = Monitor for thrombocytopenia and leukopenia Liver function tests = Monitor for liver impairment Blood glucose readings = Monitor for hyperglycemia</p> Signup and view all the answers

    Match the following patient instructions with their corresponding purposes in patients taking phenytoin:

    <p>Diligent oral hygiene = Prevent gingival hyperplasia Report mood and behavior changes = Monitor for suicidal ideation Avoid ETOH or other CNS depressants = Prevent increased sedation Report changes in skin = Monitor for Stevens-Johnson Syndrome</p> Signup and view all the answers

    Match the following symptoms with their corresponding effects on the body due to phenytoin:

    <p>Dizziness = CNS depression Gingival hyperplasia = Oral health issue Tinnitus = Auditory system issue Ataxia = Neurological issue</p> Signup and view all the answers

    Match the following patient groups with their corresponding cautions for phenytoin therapy:

    <p>Patients with thyroid disease = Monitor for thyroid function Patients with diabetes = Monitor for blood glucose readings Patients with cardiac disease = Monitor for cardiac issues Patients with liver and renal disease = Monitor for liver and renal impairment</p> Signup and view all the answers

    Match the following patient teaching instructions with their corresponding purposes in patients taking phenytoin:

    <p>Take as directed at the same time daily = Maintain therapeutic levels Do not discontinue abruptly = Prevent withdrawal symptoms Report changes in BP and HR = Monitor for cardiovascular issues Wear a medical alert bracelet = Identify medication use</p> Signup and view all the answers

    Match the following symptoms with their corresponding signs of phenytoin toxicity:

    <p>Increased sedation = CNS depression Nystagmus = Neurological issue Tremors = Neurological issue Vision changes = Visual disturbances</p> Signup and view all the answers

    Match the following instructions with their corresponding purposes in patients taking phenytoin:

    <p>Plan for travel to ensure medication supply = Prevent medication interruptions Anticipate lab monitoring = Monitor for toxicity Routine appointments = Monitor for side effects Vitamin supplementation = Prevent nutritional deficiencies</p> Signup and view all the answers

    Match the following symptoms with their corresponding potential complications of phenytoin therapy:

    <p>Thrombocytopenia = Bleeding disorders Leukopenia = Increased infection risk Liver impairment = Hepatotoxicity Hyperglycemia = Diabetic complications</p> Signup and view all the answers

    Study Notes

    Mechanism of Action

    • Phenytoin primarily acts by stabilizing neuronal membranes through the inhibition of sodium channels, thereby reducing excitability.

    Side Effects

    • A common side effect of phenytoin is gingival hyperplasia, which can be mitigated by maintaining good oral hygiene.

    Contraindications

    • Phenytoin therapy is contraindicated in patients with a known hypersensitivity to the drug or its components.

    Laboratory Monitoring

    • Patients taking phenytoin should have their serum levels monitored to ensure therapeutic effectiveness and prevent toxicity.

    Patient Instructions

    • Patients should be advised to take phenytoin consistently at the same time each day to maintain stable drug levels.

    Long-Term Effects

    • Long-term use of phenytoin may lead to bone density loss and an increased risk of osteoporosis.

    Serious Side Effects

    • Signs of severe skin reactions, such as Stevens-Johnson syndrome, require immediate medical attention when taking phenytoin.

    Travel Instructions

    • Patients should be instructed to carry their medication in original containers and ensure they have enough supply for their travels to avoid missed doses.

    Matching Symptoms with Side Effects and Toxicity

    • Side effects including dizziness and drowsiness may indicate toxicity, necessitating prompt evaluation.

    Psychological Effects

    • Chronic use of phenytoin can lead to cognitive impairment or mood changes, which should be monitored.

    Patient Cautions

    • Special caution should be exercised in patients with hepatic impairment, as phenytoin is metabolized by the liver and can accumulate.

    Surveillance Recommendations

    • Regular monitoring of complete blood counts may help detect any hematologic abnormalities associated with phenytoin use.

    Purpose of Laboratory Tests

    • Liver function tests are important to monitor due to potential hepatotoxicity from phenytoin.

    Patient Teaching

    • Educating patients on the importance of avoiding abrupt discontinuation of phenytoin to prevent seizure recurrence is crucial.

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    Description

    Test your knowledge on hydantoin medications by reviewing their mechanisms of action, indications, and common side effects. This quiz covers the nursing process involving hydantoins, including monitoring for toxicity and identifying potential adverse reactions.

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