A nurse is preparing to administer intravenous Phenytoin to a patient. Which of the following actions should the nurse take to ensure proper administration?
Flush the IV line with normal saline before and after administering phenytoin
Flush the IV line with dextrose solution before and after giving phenytoin
Mix phenytoin with lactated Ringer's solution for infusion
Administer phenytoin without flushing the IV line
The Correct Answer is A
A. Flush the IV line with normal saline before and after administering phenytoin: Phenytoin is incompatible with dextrose and many other IV solutions. Normal saline is the only recommended diluent, and flushing before and after administration prevents precipitation and line blockage, ensuring safe delivery of the drug.
B. Flush the IV line with dextrose solution before and after giving phenytoin: Phenytoin precipitates in dextrose-containing solutions, which can result in crystal formation, risking embolism or phlebitis. Using dextrose can lead to serious IV complications and must be avoided.
C. Mix phenytoin with lactated Ringer's solution for infusion: Phenytoin is not compatible with lactated Ringer’s due to the calcium content, which increases the risk of precipitation. It should only be diluted in normal saline to maintain solution stability and patient safety.
D. Administer phenytoin without flushing the IV line: Skipping the flush increases the risk of drug incompatibility, precipitation, and reduced drug delivery. Flushing with normal saline is essential to maintain IV line patency and prevent complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Flush the IV line with normal saline before and after administering phenytoin: Phenytoin is incompatible with dextrose and many other IV solutions. Normal saline is the only recommended diluent, and flushing before and after administration prevents precipitation and line blockage, ensuring safe delivery of the drug.
B. Flush the IV line with dextrose solution before and after giving phenytoin: Phenytoin precipitates in dextrose-containing solutions, which can result in crystal formation, risking embolism or phlebitis. Using dextrose can lead to serious IV complications and must be avoided.
C. Mix phenytoin with lactated Ringer's solution for infusion: Phenytoin is not compatible with lactated Ringer’s due to the calcium content, which increases the risk of precipitation. It should only be diluted in normal saline to maintain solution stability and patient safety.
D. Administer phenytoin without flushing the IV line: Skipping the flush increases the risk of drug incompatibility, precipitation, and reduced drug delivery. Flushing with normal saline is essential to maintain IV line patency and prevent complications.
Correct Answer is D
Explanation
A. Respiratory arrest and coma: These are late, life-threatening manifestations of local anesthetic systemic toxicity (LAST) that occur after CNS and cardiovascular collapse. Recognizing early signs is critical to preventing progression to this severe stage.
B. Ventricular arrhythmias and cardiac arrest: These are also late signs of LAST, resulting from the anesthetic’s depressant effects on cardiac conduction. By the time these occur, toxicity is advanced and may require immediate resuscitation measures.
C. Hypotension and tachycardia: Although cardiovascular symptoms may eventually develop, they are typically preceded by neurological signs. Early identification and management of CNS symptoms can often prevent progression to cardiovascular compromise.
D. Tinnitus, metallic taste, and perioral numbness: These are classic early signs of LAST and indicate CNS involvement. They often occur within minutes of administration and should prompt immediate intervention to stop drug absorption and initiate supportive care.
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