Please help!!! with NDx and careplan

i would disagree with you that a nursing diagnosis pertaining to the dilantin toxicity would be your #1 listed nursing diagnosis. working from maslow's hierachy of needs, this man's major problem seems to be nutrition and an infection. i'm not saying the dilantin toxicity isn't important, but the doctor is going to solve the problem by just not giving dilantin for a couple of days, whereas this man needs food and fluids to stay alive or there's going to be a dead patient who won't need a care plan anymore. question: who was responsible for giving this man his dilantin? do they know how his levels got elevated? was it just an incorrect dose, or was he overmedicating himself due to confusion on his, or his caregiver's, part?

http://www.fpnotebook.com/neu228.htm - dilantin toxicity.

normal signs and symptoms of dilantin toxicity include ataxia, slurred speech, altered levels of consciousness such as drowsiness and confusion, diplopia, tremors, headache, ventricular febrillation, and nystagmus. his lethargy and the elevated dilantin level are the two indicators you have of the elevated dilantin level to use for a nursing diagnosis. potential nursing diagnoses for this might be:

• ineffective management of therapeutic regimen r/t deficient knowledge regarding action and appropriate administration of dilantin aeb serum dilantin level of 27, lethargy, and not eating for 4 days. (http://www1.us.elsevierhealth.com/evolve/ackley/ndh7e/constructor/careplan_069.php) (http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=52)
  
• imbalanced nutrition: less than body requirements r/t dilantin intoxication aeb not eating for 4 days [this needs to be combined with his other problems of nutrition](http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=37) (http://www1.us.elsevierhealth.com/evolve/ackley/ndh7e/constructor/careplan_049.php)
  
• disturbed sensory perception:_______ r/t dilantin intoxication (http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=46) (http://www1.us.elsevierhealth.com/evolve/ackley/ndh7e/constructor/careplan_062.php)

hope that gives you enough help to get you started.