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 C
Explanation
A. "The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay.": Heparin does not enhance the effect of warfarin directly. Their mechanisms of action are different, and warfarin’s effect is delayed. Heparin is used to maintain anticoagulation until warfarin becomes effective.
B. "Both heparin and warfarin work together to dissolve the clots.": Neither heparin nor warfarin dissolves existing clots; they prevent further clot formation and allow the body’s natural fibrinolytic system to break down clots. This statement misrepresents their action.
C. "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level.": Warfarin requires 3–5 days to reach therapeutic INR levels due to its action on vitamin K-dependent clotting factors. Heparin provides immediate anticoagulation, which is why it is continued until warfarin is therapeutic.
D. "I will call the provider to get a prescription for discontinuing the IV heparin today.": Discontinuing heparin too soon places the patient at risk for clot progression or embolization, as warfarin will not yet be therapeutic. The nurse should understand and educate the patient about the rationale for overlap.
Correct Answer is A
Explanation
A. "All antipsychotic drugs carry an equal risk of causing movement-related side effects.": First-generation antipsychotics like Haloperidol are more likely to cause extrapyramidal symptoms due to their potent dopamine D2 receptor blockade. Second-generation antipsychotics carry a lower risk, making this statement inconsistent with clinical evidence.
B. "These side effects happen because this drug blocks dopamine in certain parts of my brain.": Extrapyramidal symptoms are primarily due to dopamine blockade in the nigrostriatal pathway, which regulates motor control. Interference in this region leads to tremors, rigidity, and other movement disorders.
C. "Taking other drugs with my Haloperidol can increase the risk of extrapyramidal symptoms.": Concurrent use of medications that also affect dopamine pathways or have sedative effects can increase the likelihood of developing EPS. Drug interactions are a significant factor in overall risk.
D. "Tardive dyskinesia occurs with prolonged use of an antipsychotic drug.": Long-term use of dopamine-blocking agents, especially at high doses, can lead to tardive dyskinesia. This condition involves involuntary movements and may be irreversible, particularly in older adults.
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