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. Risperidone is an atypical antipsychotic primarily used to treat schizophrenia and bipolar disorder, not first-line treatment for depression.
B. Haloperidol is a typical antipsychotic used mainly for acute psychosis and agitation, not for treating depression.
C. Paroxetine is a selective serotonin reuptake inhibitor (SSRI) that is widely recognized as a first-line treatment for depression due to its efficacy and relatively favorable side effect profile.
D. Clozapine is an atypical antipsychotic reserved for treatment-resistant schizophrenia and is not indicated for the treatment of depression.
Correct Answer is D
Explanation
A. Diabetes Mellitus is not a contraindication for promethazine, although caution may be needed regarding metabolic control.
B. Chronic Kidney Disease does not specifically contraindicate the use of promethazine, but dosage adjustments may be necessary due to altered drug metabolism.
C. Iron Deficiency Anemia does not contraindicate the use of promethazine and would not raise significant concerns for its administration.
D. Narrow-Angle Glaucoma is a contraindication for promethazine due to its anticholinergic properties, which can increase intraocular pressure and worsen glaucoma.