Patient Care and Monitoring Brain Metastasis

1. Assess patient symptoms for prompt referral for radiation or surgery.

2. For patients receiving corticosteroids, monitor for adverse effects and drug interactions. Does the patient need GI prophylaxis for long-term treatment? Slowly taper once symptoms improve and/or radiation or surgery is completed.

3. Evaluate the patient for drug interactions, allergies, and adverse effects with phenytoin or corticosteroid therapy.

4. Instruct patients receiving phenytoin about symptoms of elevated serum concentrations (nystagmus, blurred vision, dizziness, drowsiness, lethargy).

5. Provide patient education regarding when to take medications, importance of compliance, and promptly report symptoms of recurrence (mental status changes, seizures).

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