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:

Calculating the total intake includes converting ounces to milliliters and adding all fluid intakes. 4 oz juice equals 120 mL, 6 oz hot tea equals 180 mL, ice chips are counted as half their volume, so 100 mL ice chips equals 50 mL, 150 mL IV bolus, and 8 oz broth equals 240 mL. Adding these up: 120 + 180 + 50 + 150 + 240 = 740 mL. Choice A, 600 mL, underestimates the total intake, excluding necessary details in the calculation.

Choice B reason:

To record the correct intake, conversion of all quantities into milliliters is crucial: 4 oz juice (120 mL), 6 oz hot tea (180 mL), 100 mL ice chips (50 mL), 150 mL IV bolus, and 8 oz broth (240 mL), totaling 120 + 180 + 50 + 150 + 240 = 740 mL. 740 mL closely aligns with Choice B (700 mL). Slight discrepancy is due to rounding or estimate in practical settings, making Choice B the most accurate.

Choice C reason:

800 mL inaccurately inflates the total intake. Accurate calculation yields 740 mL as the total fluid intake, considering all conversions and additions. Choice C misrepresents this value.

Choice D reason:

900 mL is another overestimate. Proper conversion and summation of all fluids indicate the total intake is 740 mL. Choice D is significantly higher than this calculated total, demonstrating the importance of precise conversion and addition for accurate records.

Choice A reason: Bradycardia is not typically associated with gastrointestinal perforation. While changes in heart rate can occur with severe pain or shock, it is not a primary indicator of perforation in peptic ulcer disease.

Choice B reason: This is the correct answer. Sudden abdominal pain, especially if severe and accompanied by signs of peritonitis, is a key indicator of gastrointestinal perforation. This condition requires immediate medical intervention to prevent serious complications.

Choice C reason: Hyperactive bowel sounds are more commonly associated with other gastrointestinal conditions, such as obstruction or gastroenteritis. In the case of perforation, bowel sounds may actually be diminished or absent.

Choice D reason: Increased blood pressure might occur as a response to severe pain or stress but is not a specific indicator of gastrointestinal perforation. The focus should be on abdominal symptoms and signs of acute abdomen.