A patient reports a skin rash while taking phenytoin. What is an appropriate nurse response?

• A. Skin rash is an adverse effect. Your healthcare provider will follow up with you for further instructions.
• B. Stop the medication immediately and contact emergency services.
• C. Rash is a normal and expected side effect requiring no action.
• D. Switch to another anticonvulsant immediately.

Answer: (A)

Skin rash from phenytoin is a potential adverse reaction that needs clinical evaluation. The appropriate nurse response is to acknowledge the rash as an adverse effect and tell the patient that the healthcare provider will follow up for further instructions. This approach ensures the reaction is assessed for severity, potential progression, and the need to adjust or switch therapy, rather than assuming it’s harmless or requiring immediate emergency action.

Rash alone doesn’t automatically mean stopping the drug or calling emergency services—that decision depends on how severe it is and whether there are signs of a serious hypersensitivity reaction (such as widespread blistering, mucous membrane involvement, fever, or trouble breathing). Therefore, reporting and awaiting provider guidance is the safest next step.