— 藥理與非經腸給藥 · MEDIUM · SATA —
護理師指導病人開始服用苯妥英鈉（Phenytoin）控制癲癇。應包含哪些衛教內容？（選所有適合的）
A nurse is educating a client starting on phenytoin for seizure control. Which statements should the nurse include? (Select all that apply.)
- AMaintain meticulous oral hygiene✓ 正解維持精細的口腔衛生
- BDo not stop the medication abruptly✓ 正解勿突然停止服藥
- CReport a skin rash immediately✓ 正解立即報告皮疹
- DTake the dose with a high-calcium diet隨高鈣飲食服藥
- ERegular monitoring of serum drug levels is required✓ 正解需定期監測血清藥物濃度
— Explanation · 中文詳解 —
Phenytoin 副作用包括牙齦增生（需加強口腔清潔）、嚴重皮膚紅疹（如史蒂芬強生症候群）、停藥可能導致癲癇重積狀態，以及具狹窄治療指數需監測血中濃度。D 錯誤，高鈣飲食與藥物吸收無直接正面關聯，且應避免影響吸收的食物。此藥需長期規律服用，擅自停藥是臨床大忌。
Clients taking phenytoin must maintain meticulous oral hygiene to manage gingival hyperplasia, report any skin rash immediately due to the risk of Stevens-Johnson syndrome, and never stop the medication abruptly to prevent status epilepticus. Additionally, regular monitoring of serum drug levels is crucial because phenytoin has a narrow therapeutic index.
✦ 台美臨床差異
台美對於癲癇衛教內容相似，唯美國護理師在社區護理層面會更強調病人攜帶識別手環（MedicAlert），台灣則較著重於家屬的急救指導。