Final answer:
The nurse should prioritize monitoring for phenytoin toxicity, maintaining optimal therapeutic levels, and addressing drug metabolism issues in a patient on long-term phenytoin therapy. They should also consider dosage based on mass and collaborate with the care team to ensure comprehensive patient care.
Step-by-step explanation:
Prioritizing Care for a Patient on Long-term Phenytoin Therapy:
A patient who has been on long-term phenytoin (Dilantin) therapy is admitted to the unit. Given the potential for adverse effects, the nurse should prioritize monitoring for signs of toxicity, ensuring that optimal therapeutic drug levels are maintained without causing significant side effects. It is crucial to understand the patient's medical history and any underlying conditions such as liver or kidney dysfunction that could affect drug metabolism. This careful balance strives to minimize risks while managing the patient’s condition effectively. Part of the patient's plan of care should also include a review of potential interactions with other medications, vigilance for signs of adverse reactions, and education about the importance of adherence to the prescribed dosage and route of administration. The patient's mass may also be considered when determining the appropriate dosage, especially if the patient demonstrates substantial deviation from the mass used to establish the standard dose.
The multidisciplinary team, including the surgeon, the nurse, and the anesthesia professional, should collaboratively work to ensure a comprehensive approach to patient care, reviewing all key concerns including phenytoin levels, potential interactions, and patient education. Additionally, the team should follow an appropriate pharmacovigilance system to continue monitoring for long-term safety and effects of the medication.