A nurse teaches a client newly prescribed phenytoin about or… | MyMerci
Medical EmergenciesPA
Question
A nurse teaches a client newly prescribed phenytoin about oral self-care. Which instruction is most important to prevent a common long-term side effect?
1Avoid green leafy vegetables to prevent drug interactions
2Take the medication only with high-fat meals
3Brush teeth twice daily, floss, and schedule dental cleanings every 3-6 months✓ Correct answer
4Increase fluid intake to dilute the medication
Explanation
Correct (2): Gingival hyperplasia develops in up to 50% of phenytoin users from fibroblast proliferation in gum tissue. Diligent oral hygiene — brushing, flossing, and dental cleanings every 3-6 months — significantly reduces severity. (1) Green leafy vegetable restriction is for warfarin, not phenytoin. (3) Phenytoin can be taken with or without food; high-fat is not required. (4) Hydration does not affect phenytoin level meaningfully.
In-depth explanation
Memory Tip Phenytoin = "5 Hs" — Hyperplasia (gums), Hirsutism, Hyperglycemia, Hyperkinesia in kids, Hypotension (IV). Patient Teaching Tell the dentist about phenytoin at every visit.
Clinical scenario
Scenario 22-year-old college student newly diagnosed with generalized tonic-clonic seizures starting phenytoin 300 mg PO daily. Receiving outpatient teaching.
Key concepts
Gingival hyperplasia — Overgrowth of gum tissue; common phenytoin adverse effect mitigated by oral hygiene.
Oral hygiene — Brushing, flossing, and dental visits; preventive measure against phenytoin-induced gingival hyperplasia.
Hirsutism — Excessive hair growth; another cosmetic side effect of phenytoin especially troubling in adolescents.