A nurse is caring for a client who has been taking phenytoin (Dilantin). The nurse understands that which of the following is a long-term adverse effect of this medication?
Hair loss
Seizures
Hypertension
Gingival hyperplasia
The Correct Answer is D
A. Hair loss is not a recognized long-term side effect of phenytoin.
B. Phenytoin is used to prevent seizures, not cause them; a reoccurrence of seizures may indicate ineffective control or medication issues, but it is not a side effect.
C. Hypertension is not typically associated with phenytoin use.
D. Gingival hyperplasia, or overgrowth of gum tissue, is a common long-term side effect of phenytoin and requires regular dental hygiene and monitoring.
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Correct Answer is C
Explanation
A. While liver failure may affect excretion indirectly, it primarily impacts metabolism more significantly.
B. Absorption is typically not directly affected by liver function, though it can be influenced by other factors.
C. The liver is crucial for drug metabolism; chronic liver failure impairs the liver's ability to metabolize medications effectively, leading to potential toxicity.
D. Distribution may be altered due to changes in plasma proteins or blood flow, but the most significant impact occurs in metabolism.
Correct Answer is A
Explanation
A. Hypokalemia increases the risk of digoxin toxicity because low potassium levels enhance digoxin's effects on the myocardium. Monitoring and correcting potassium levels is essential in clients on digoxin.
B. Hypophosphatemia is not directly linked to digoxin toxicity and is not a primary concern.
C. Hypocalcemia does not increase the risk of digoxin toxicity; in fact, hypercalcemia would be more concerning in terms of potential toxicity.
D. Hypernatremia does not have a significant effect on digoxin toxicity, so it is not a primary concern when assessing this medication’s safety.