— 藥理與非經腸給藥 · HARD · SATA —
護理師對開始服用苯妥英（Phenytoin）控制癲癇的病人進行衛教，應包含哪些內容？（選所有適合的）
A nurse is educating a client starting phenytoin therapy for seizure control. Which statements should the nurse include in the teaching? (Select all that apply.)
- APerform thorough oral hygiene with a soft-bristled toothbrush✓ 正解使用軟毛牙刷進行徹底口腔衛生
- BAvoid stopping the medication abruptly✓ 正解避免突然停止用藥
- CReport any development of a new rash immediately✓ 正解立即報告任何新出現的皮疹
- DIncrease intake of calcium and vitamin D✓ 正解增加鈣質和维生素 D 的攝取
- EMonitor blood glucose levels daily每日監測血糖水平
— Explanation · 中文詳解 —
苯妥英常見副作用為牙齦增生，需加強口腔清潔。此藥嚴禁突然停藥，否則恐引發癲癇重積狀態。若出現皮疹需立即就醫，警惕史蒂芬強生症候群（SJS）。此外，長期服用會影響維生素 D 代謝，需額外補充鈣質與維生素 D。監測血糖非該藥常規衛教項目。
Phenytoin therapy requires strict adherence to oral hygiene to prevent gingival hyperplasia and gradual tapering to avoid withdrawal seizures. Clients must report rashes immediately due to the risk of Stevens-Johnson syndrome and should supplement calcium and vitamin D, as the drug impairs vitamin D metabolism and bone health.
✦ 台美臨床差異
美台臨床對 Phenytoin 的處置與衛教重點相當，但在台灣，由於保險規範，長期使用者的骨質密度監測更受重視。