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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The nurse should identify the concerns that the client has regarding to the medications prescribed. This allows the nurse and the provider to demystify any incorrect information the client might have or address any other underlying issues.
A. Just documenting does not address the client’s issues and shows lack of empathy
C. Explaining is important but the reason for refusal could be something else
D. The nurse should not use any reason to try and force the client to take the medications
Correct Answer is D
Explanation
Aluminum compounds have a constipating effect due to reduced bowel movements and potential discomfort.
A. Flatulence is less common with aluminum hydroxide compared to magnesium-containing antacids.
B. Headache is not a common side effect of aluminum hydroxide.
C. Palpitations are not a known adverse reaction to aluminum hydroxide.
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