A nurse is preparing to administer phenytoin 75 mg PO every 6 hours. Available is phenytoin 25 mg/5 mL. How many mL should the nurse administer?

(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Choice A reason:

Lactose intolerance affects digestive efficiency but does not increase aspiration risk. It primarily causes gastrointestinal symptoms like bloating and diarrhea without impairing swallowing mechanisms.

Choice B reason:

A cerebrovascular accident (stroke) can impair swallowing (dysphagia) due to neurological deficits, significantly raising aspiration risk. These clients need careful assessment and possibly modified diets to prevent aspiration.

Choice C reason:

Prolonged diarrhea affects fluid and electrolyte balance but does not directly compromise swallowing ability. It’s more related to digestive health rather than risks associated with aspiration.

Choice D reason:

Trauma to the head and neck can damage the nerves or structures involved in swallowing, markedly increasing the risk of aspiration. These clients often require detailed assessment and sometimes alternative feeding methods to prevent aspiration.

Choice E reason:

Postoperative clients, especially those recently under general anesthesia, are at risk due to residual effects of anesthesia which can depress the reflexes that protect the airway. Hence, their swallowing function may be temporarily impaired, heightening the risk of aspiration.

Choice A reason:

Fat embolism syndrome is a serious complication of fractures, particularly long bone fractures, and presents with symptoms such as respiratory distress, cerebral dysfunction, and petechial rash. However, it is not characterized by localized increasing edema and pain.

Choice B reason:

Malignant hyperthermia is a severe reaction to certain anesthetic agents and is characterized by hyperthermia, muscle rigidity, and metabolic acidosis. It is not related to increasing edema and pain in the context of a crush injury.

Choice C reason:

Acute compartment syndrome is characterized by increasing pain that is not relieved by analgesics and increasing edema due to increased pressure within the muscle compartments. This condition requires immediate medical intervention to prevent permanent damage.

Choice D reason:

A myocardial embolus would present with symptoms related to cardiac function, such as chest pain and shortness of breath. It is not related to localized increasing edema and pain in the lower extremities following a crush injury.