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 D
Explanation
A. A shuffling gait is more commonly associated with parkinsonism, a side effect of antipsychotic medications, rather than tardive dyskinesia.
B. A sudden onset of high fever could indicate neuroleptic malignant syndrome (NMS), which is a serious reaction to antipsychotic medications, not tardive dyskinesia.
C. Constant tapping of feet when sitting can indicate restlessness or akathisia, but it does not specifically represent tardive dyskinesia.
D. Twisting tongue movements are a classic manifestation of tardive dyskinesia, characterized by involuntary, repetitive movements of the face, tongue, and extremities, which may develop after long-term use of antipsychotic medications like fluphenazine.
Correct Answer is D
Explanation
A. Hydralazine is a vasodilator that does not directly replace ACE inhibitors and is not the preferred alternative for managing hypertension or heart failure.
B. Metoprolol is a beta-blocker that is used for different indications and is not a direct substitute for ACE inhibitors.
C. Furosemide is a loop diuretic used for fluid management, not as an alternative to ACE inhibitors.
D. Losartan is an angiotensin II receptor blocker (ARB) and serves as a suitable alternative to ACE inhibitors for patients who experience a cough from them, as ARBs do not typically cause this side effect.