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 C

Explanation

Docusate sodium is used as a stool softener in these cases to promote bowel movements. Adequate water intake increases hydration and also works synergistically to promote bowel movements increasing its effectiveness.
A. Taking docusate on an empty stomach is not necessary. It can be taken with or without food.
B. Abdominal pain is not a common side effect of docusate. In fact, it is usually well tolerated.
D. There is no specific requirement to avoid taking docusate before bedtime. It can be taken at any time of day as directed by the healthcare provider.

A. Take an antiemetic 1 hr following administration. B. Take the medication with an NSAID. C. Drink 2 to 3 L Of water per day. D. Rinse mouth 2 times per day with an alcohol-based mouthwash.

Correct Answer is C

Explanation

Methotrexate causes hyperuricemia which may predispose to kidney stones. Adequate hydration help flush out the uric acid preventing stone formation
A-Although methotrexate can cause nausea and vomiting, this does not always happen, therefore, no need for the antiemetic before intake
B-Taking methotrexate with an NSAID increases risk of gastrointestinal irritation
D-Methotrexate cause stomatitis which may be aggravated by use of alcohol-based mouth wash

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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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