A nurse is preparing to administer phenytoin 50 mg IV bolus to a client Who has a seizure disorder. The medication is supplied as a 50 mg/mL vial. Which of the following actions should the nurse take?

Dilute the medication with sterile water before injecting.

Administer the medication over 1 min.

Follow the IV injection with sterile water.

Slow the injection if the medication crystallizes.

Answer and Explanation

The Correct Answer is B

A.   Diluting phenytoin with sterile water before injecting is not recommended, as phenytoin is incompatible with most used diluents. Diluting it can lead to precipitation and potentially cause adverse effects such as tissue irritation and phlebitis.
B.   Administering the medication over 1 min is recommended. Phenytoin should be administered at a rate of 50mg/min.
C.   Following the IV injection with sterile water is unnecessary and not indicated for administering phenytoin.
D. Phenytoin precipitates out of solution when mixed with certain diluents or when administered too quickly. Crystallized phenytoin can cause local irritation, tissue damage, and potentially more serious adverse effects. Therefore, it should not be administered at all.

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Correct Answer is A

Explanation

flank pain is a typical symptom of urolithiasis (renal or ureteric). The presence of a stone in the urinary tract stretches the tract leading to pain. Calcium supplementation increases the risk of calcium stone formation in the urinary tract.

B. calcium supplements do not cause hepatitis

C. Calcium supplementation do not cause peptic ulcers

D. Calcium stones have been implicated in pancreatic but this presents with epigastric pain

A. “Warm the ointment by placing the tube in glass of hot tap water” B. "Discard the first bead of ointment before each application." C. "Instruct your child to squeeze his eyes shut following application." D. "Cleanse the eye with a wet cotton ball in a direction towards the inner canthus before applying the ointment."

Correct Answer is B

Explanation

the first bead of ointment may be contaminated with bacteria from the tip of the tube or the surrounding skin. Discarding this initial bead ensures that the subsequent application is sterile and reduces the risk of introducing infection into the eye.

A. Warming the ointment by placing the tube in hot tap water alters the consistency of the ointment and can potentially cause burns to the child's delicate eye tissue.

C. Instructing the child to squeeze his eyes shut following application is not necessary. The eyes should be closed gently

D. Cleansing the eye should be done from the inner corner moving outward

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A nurse is preparing to administer phenytoin 50 mg IV bolus to a client Who has a seizure disorder. The medication is supplied as a 50 mg/mL vial. Which of the following actions should the nurse take?

Nursing Test Bank

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