Exhibits

The healthcare provider comes to the bedside following the seizure and prescribes phenytoin. The nurse administers the phenytoin as prescribed. Which possible side effect(s) of phenytoin should the nurse assess for after administration? Select all that apply.

Vomiting

Altered blood coagulation

Visual disturbances

Drowsiness

Aphasia

Ataxia

Answer and Explanation

Correct Answer : B,C,D,F

A.   Vomiting is not a common side effect of phenytoin but could occur in some patients. It’s more likely a
reaction to the medication rather than a frequent side effect.
B.   Phenytoin can affect blood coagulation. It may interfere with vitamin K metabolism, which can alter coagulation pathways and increase the risk of bleeding or bruising. Monitoring for signs of bleeding or changes in clotting status is important, particularly in patients on long-term therapy.
C.   Visual disturbances, including nystagmus (involuntary eye movements), double vision, or blurred vision, can occur with phenytoin use. This side effect is related to the medication’s impact on the nervous system.
D.   Drowsiness is a common side effect of many antiepileptic drugs, including phenytoin. It can affect the client’s alertness and overall level of consciousness, making it important for the nurse to monitor and address any related safety concerns.
E.   Aphasia, or difficulty with language and speech, is not a typical side effect of phenytoin. While phenytoin affects the central nervous system, aphasia is not commonly reported with its use.
F.   Ataxia, or lack of coordination and unsteady movements, is a known side effect of phenytoin. This occurs due to its effects on the nervous system and can impair motor skills and coordination.

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Correct Answer is C

Explanation

A. Chips and pretzels are high in sodium, which can contribute to fluid retention and exacerbate symptoms of CVI. While reducing sodium intake can help manage fluid retention and swelling, it is not the most direct action for promoting circulation itself. It’s more of an adjunctive measure that can support overall management of CVI but does not directly improve venous circulation.
B. Mountain biking is an intense physical activity that may not be suitable for all clients with chronic venous insufficiency, especially if they have significant symptoms or mobility issues. High-impact exercises can potentially exacerbate symptoms or lead to injury. Low-impact activities are generally recommended to improve circulation and manage CVI.
C. Elevating the lower extremities is a highly effective measure for promoting circulation in clients with chronic venous insufficiency. It helps reduce venous pressure and promotes the return of blood to the heart, thereby alleviating swelling and discomfort. This action is directly beneficial in managing CVI.
D. Restricting fluid intake to water alone does not directly address the underlying issues of venous insufficiency. While managing overall fluid intake can be part of a comprehensive plan to prevent excessive fluid retention, it is not the most direct or effective action for promoting circulation compared to elevating the legs.

A. Discard the incorrectly dialed dose and recalibrate the insulin pen. B. Save the dialed dose and prepare the correct dose using a syringe C. Assist the client to administer 24 units of the dialed dose, and waste the remainder. D. Advise the client to dial down to the correct dose, which can then be administered.

Correct Answer is A

Explanation

A. This is the safest and most accurate option. Insulin dosing is critical, and an overdose can lead to hypoglycemia, a serious condition. By discarding the incorrect dose and starting anew, the nurse ensures the client receives the precise amount of insulin prescribed.
B. This option is inefficient and increases the risk of error. It involves using two different methods for insulin administration, which can lead to confusion and potential mistakes. Additionally, it doesn't address the initial error of dialing the incorrect dose.
C. This option is extremely dangerous. Administering more insulin than prescribed can lead to severe hypoglycemia. Wasting the remaining four units does not rectify the primary issue of the overdose.

D. Insulin pens are designed for precision. Altering the dialed dose after an error can compromise the accuracy of the insulin delivery system. This method is not reliable and can lead to inaccurate dosing.

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Exhibits The healthcare provider comes to the bedside following the seizure and prescribes phenytoin. The nurse administers the phenytoin as prescribed. Which possible side effect(s) of phenytoin should the nurse assess for after administration? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which nursing action is most helpful in promoting circulation in a client with chronic venous insufficiency?

Correct Answer is C

Explanation

When learning to use an insulin pen, a client with diabetes dials 28 units of regular insulin instead of 24 units, the prescribed dose. Which action should the nurse take?

Correct Answer is A

Explanation

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Exhibits

The healthcare provider comes to the bedside following the seizure and prescribes phenytoin. The nurse administers the phenytoin as prescribed. Which possible side effect(s) of phenytoin should the nurse assess for after administration? Select all that apply.