Question

The child with seizure disorder is being treated with Dilantin (phenytoin). Which of the following statements by the patient's mother indicates to the nurse that the patient is experiencing a side effect of Dilantin therapy? A. "She is very irritable lately." B. "She sleeps quite a bit of the time." C. "Her gums look too big for her teeth." D. "She has gained about 10 pounds in the last 6 months."

Short answer

Answer: C. "Her gums look too big for her teeth." Explanation: Dilantin (phenytoin) is an antiepileptic medication used to control seizures. Some of its common side effects include dizziness, drowsiness, headache, nausea, vomiting, constipation, and gingival hyperplasia (overgrowth of the gums). The patient's mother's statement, "Her gums look too big for her teeth," is a sign of gingival hyperplasia, a known side effect of Dilantin therapy.

Step-by-step solution

Understand the question and the medication

First, we need to understand the question, which is asking us about the side effects of Dilantin (phenytoin) therapy. Dilantin is an antiepileptic medication used to control seizures. Begin by gathering information about the common side effects of Dilantin therapy.

Identify the common side effects of Dilantin (phenytoin) therapy

Research or consult a reference material to learn about the common side effects of Dilantin therapy. Some potential side effects include dizziness, drowsiness, headache, nausea, vomiting, constipation, and gingival hyperplasia (overgrowth of the gums).

Evaluate the statements provided by the patient's mother

Go through each statement provided by the patient's mother, and determine if any of them match the common side effects of Dilantin (phenytoin) therapy. A. "She is very irritable lately." B. "She sleeps quite a bit of the time." C. "Her gums look too big for her teeth." D. "She has gained about 10 pounds in the last 6 months."

Choose the statement that matches a common side effect of Dilantin therapy

From the list of statements, only one matches a common side effect of Dilantin (phenytoin) therapy: C. "Her gums look too big for her teeth." (This is a sign of gingival hyperplasia, which is a known side effect of Dilantin therapy)

Conclusion

Therefore, the correct answer to the question is C. "Her gums look too big for her teeth." This statement by the patient's mother indicates that the patient is experiencing a side effect of Dilantin (phenytoin) therapy.

Key concepts

Seizure Disorder Management

Managing seizure disorders is crucial to maintaining the quality of life for individuals affected by them. Seizures occur due to abnormal electrical activity in the brain, leading to various physical symptoms such as muscle spasms, loss of consciousness, and behavioral changes. Effective management involves a comprehensive approach that includes the right medications, lifestyle adjustments, and regular monitoring. Medical professionals play a key role in determining the appropriate anti-seizure medications or combination of medications, tailored to the individual's specific type of seizure and its severity. Consistent follow-ups and adjustments are often needed, as seizures can change over time.
In addition to medications, lifestyle changes can help manage seizure disorders effectively. Ensuring adequate sleep, maintaining a balanced diet, and avoiding triggers such as flashing lights and stress are important. Families and caregivers should also be educated on seizure first aid to provide immediate assistance during a seizure episode, ensuring safety and minimizing injuries for the patient. Regular consultations with healthcare providers ensure that the management plan remains effective and is adjusted as needed.

Antiepileptic Medications

Antiepileptic medications are the cornerstone of seizure management and are designed to stabilize electrical activity in the brain. Phenytoin, commonly known under the brand name Dilantin, is one such medication prescribed to control seizures. It works by reducing the motor cortex's activity to prevent convulsions. Side effects are a critical consideration when using these medications. While they are effective in managing seizures, they may lead to unwanted side effects that can impact daily life. Common side effects of antiepileptic drugs like phenytoin include drowsiness, dizziness, and, in some cases, gingival hyperplasia, which is an overgrowth of the gums. Patients should always be monitored to balance the benefits of seizure control with potential side effects.
If a patient experiences troubling side effects, it is important to communicate with a healthcare provider who can reconsider the dosage or suggest alternative medications. Regular blood tests may also be required to ensure the levels of medication in the blood remain therapeutic and to prevent toxicity. The goal is to achieve the maximum possible seizure control with the fewest side effects.

Gingival Hyperplasia

Gingival hyperplasia is a common side effect associated with the use of certain antiepileptic drugs, like phenytoin. This condition is characterized by the overgrowth of gum tissue, causing the gums to appear larger than usual and may "look too big for the teeth," as many patients describe it. Such a condition not only affects oral aesthetics but can also lead to problems with oral hygiene and dental health.
The exact cause of gingival hyperplasia is not fully understood, but it is believed to involve inflammatory processes in response to the medication. Good oral hygiene can mitigate the severity of this side effect. Regular brushing, flossing, and visits to a dentist help keep the gums healthy and prevent or reduce overgrowth. If gingival hyperplasia becomes severe, a dentist or healthcare professional may recommend surgical interventions to remove excess gum tissue. It's essential for individuals taking phenytoin to be aware of this potential side effect and engage in preventive measures actively. Maintaining open communication with healthcare providers ensures that symptoms are addressed promptly and necessary adjustments are made to the treatment plan.