Which assessment finding requires immediate attention in a client treated with phenytoin?

The identification of elevated liver enzymes as an assessment finding requiring immediate attention in a client treated with phenytoin is grounded in the potential for serious hepatic complications associated with the medication. Phenytoin is known to have hepatotoxic effects, particularly when used over long periods or at high doses. Elevated liver enzymes (such as AST and ALT) may signal liver inflammation or damage, which can lead to conditions like hepatotoxicity or liver failure if not addressed promptly.

Monitoring liver function is critical during phenytoin therapy due to the drug's metabolic pathway involving the liver and its interaction with liver enzymes. An increase in liver enzymes indicates that the liver is under stress and may not be able to process medication effectively, which can exacerbate the risk of adverse effects and toxicity.

The other options, while potentially significant, do not present an immediate risk in comparison. Persistent nausea may indicate gastrointestinal upset or medication intolerance, but it doesn't necessarily require urgent intervention. A phenytoin level below the therapeutic range signifies that the drug may not be adequately controlling seizures, yet it is not as acutely dangerous and can be managed with dose adjustments. A decrease in seizure frequency is generally a positive outcome, indicating improved control of the client's seizures.

In conclusion, the