Medical Surgical Seizures #13

Question

The nurse is assessing a client who has been on phenytoin for 10 years. Which characteristic finding is observed in clients with a long-term history of taking phenytoin sodium?

Answers

  1. Excessive growth of gum tissue.
    • Rationale:

      This answer is correct because long-term use of phenytoin can cause gingival hyperplasia (excessive growth of gum tissue). The client should be instructed to have good oral hygiene and to follow-up at least every 6 months with the dentist to have this potential complication of phenytoin monitored.

  2. Enlarged tonsils.
    • Rationale:

      This answer is not correct because enlarged tonsils are not associated with phenytoin therapy. Usual side effects to monitor a client for on phenytoin therapy includes gingival hyperplasia (excessive growth of gum tissue), and CNS effects, such as nystagmus, slurring speech, lethargy, coma, or death.

  3. Dry scaly skin.
    • Rationale:

      This answer is not correct because dry, scaly skin is not associated with phenytoin therapy. A skin rash can be associated with phenytoin therapy but is generally not serious. Report any redness or rash to the health care provider since it could be associated with the beginning of a rare, but life-threatening skin condition, Stevens-Johnson syndrome.

  4. Mania
    • Rationale:

      This answer is not correct because mania is not associated with phenytoin therapy. On the other hand, depression can occur during any stage of phenytoin therapy and should be reported to the health care provider.

Overview

Phenytoin is used to prevent and treat seizures. Long-term use of phenytoin can cause gingival hyperplasia (excessive growth of gum tissue).

Explanation

Learning Outcomes

Phenytoin is an anti-epileptic or anticonvulsant medication used to prevent and treat certain types of seizures. It works by decreasing the impulse activity in the brain that can cause seizures. Long-term use of phenytoin can cause gingival hyperplasia (excessive growth of gum tissue). The client should be instructed to have good oral hygiene and to follow-up at least every 6 months with the dentist to have this potential complication of phenytoin monitored. Self-monitoring should be taught to the client and any change of the gums reported to the health care professional.

Test Taking Tip

The nursing student preparing for NCLEX will be wise to remember unusual side effects associated with certain medications. Phenytoin and gingival hyperplasia is a very unique side effect which should be put to memory.

Video Rationale