Question

the nurse understands that phenytoin should be used with caution in patients with which comorbid conditions? select all that apply. hirsutism gingival hyperplasia porphyria hypothyroidism cardiac disease

Explanation:

• Hirsutism: Phenytoin can cause hirsutism (excessive hair growth), but this is an adverse effect, not a comorbid condition where caution is needed for use. So this is not a correct choice.
• Gingival hyperplasia: Phenytoin can cause gingival hyperplasia, again an adverse effect, not a comorbid condition requiring caution in use. Not a correct choice.
• Porphyria: Phenytoin is contraindicated or should be used with extreme caution in patients with porphyria, as it can exacerbate porphyric attacks. So this is a correct choice.
• Hypothyroidism: Phenytoin can interfere with thyroid hormone metabolism, so in patients with hypothyroidism, its use needs caution as it may affect thyroid function further. Correct choice.
• Cardiac disease: Phenytoin can have cardiac effects (e.g., arrhythmias), so in patients with cardiac disease, its use should be cautious. Correct choice.

Answer:

C. Porphyria, D. Hypothyroidism, E. Cardiac disease