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 B
Explanation
A. Cherries do not contain tyramine, which is the compound of concern for clients on MAOIs, so they can be included in the diet.
B. Cheddar cheese is high in tyramine, which can lead to hypertensive crises when consumed by clients taking MAOIs. Therefore, it should be eliminated from the diet.
C. Chicken is generally safe for clients on MAOIs as it does not contain significant amounts of tyramine.
D. Fresh fish is also safe to consume while on MAOIs as long as it is fresh and not aged, fermented, or spoiled, which could contain higher tyramine levels.
Correct Answer is C
Explanation
A. PT/INR is not the appropriate measure for heparin therapy, as heparin is monitored using activated partial thromboplastin time (aPTT). This response could mislead the client regarding treatment expectations.
B. While it may take time to reach therapeutic levels, this statement doesn't clarify that heparin is not a clot-dissolving agent.
C. Heparin prevents the extension of existing clots and the formation of new clots but does not actively dissolve clots already present.
D. This statement incorrectly suggests that immediate effects are seen, which is not the case as heparin's action involves prevention rather than dissolution.