The nurse is preparing to administer phenytoin to a patient who has a seizure disorder. The patient appears drowsy, and the nurse notes that the last random serum drug level was 18 mcg/mL. What action will the nurse take?
Administer the dose since the patient is not toxic
Contact the provider to discuss decreasing the phenytoin dose
Give the drug and monitor closely for adverse effects
Report drug toxicity to the providers
The Correct Answer is D
A. Administer the dose since the patient is not toxic.
This is not the appropriate action. With a drowsy patient and a high serum phenytoin level, there is a concern for toxicity. Administering the next dose could worsen the toxicity.
B. Contact the provider to discuss decreasing the phenytoin dose.
While adjusting the dose may be a consideration, the immediate action should be to withhold the next dose and report the elevated level to the healthcare provider. The provider can then determine the appropriate course of action.
C. Give the drug and monitor closely for adverse effects.
Giving the drug without further intervention is not appropriate when there are signs of potential toxicity, such as drowsiness. Monitoring alone is not sufficient in this case.
D. Report drug toxicity to the providers.
This is the correct choice. With a drowsy patient and a serum phenytoin level of 18 mcg/mL, which is considered high, reporting the drug toxicity to the healthcare provider is the immediate and appropriate action. The provider can then determine the next steps, such as adjusting the dose or ordering additional tests.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Depression:
CNS stimulants are generally not indicated for depression. In fact, they can exacerbate symptoms and are not considered a first-line treatment for depressive disorders.
B. Opiate overdose:
CNS stimulants are not indicated for treating opiate overdose. In cases of overdose, other medications like naloxone are commonly used to reverse the effects of opioids.
C. Poor appetite:
CNS stimulants may be used to increase alertness and decrease fatigue, but they are not typically prescribed to address poor appetite. Appetite stimulation is often managed through other approaches.
D. Narcolepsy:
This is the correct answer. CNS stimulants, such as modafinil or methylphenidate, are commonly prescribed to manage symptoms of narcolepsy. These medications help improve wakefulness and reduce excessive daytime sleepiness.
Correct Answer is A
Explanation
A. Carbidopa-levodopa
The symptoms described, including a shuffling gait, lack of facial expression, and tremors at rest, are characteristic of Parkinson's disease. Carbidopa-levodopa is a common medication used in the management of Parkinson's disease.
B. Donepezil
Donepezil is used in the treatment of Alzheimer's disease, a condition characterized by cognitive decline and memory impairment. It is not indicated for Parkinson's disease.
C. Rivastigmine
Rivastigmine is another medication used in the treatment of Alzheimer's disease, and it is also used in Parkinson's disease dementia. However, it is not the primary medication for the motor symptoms of Parkinson's disease.
D. Tacrine
Tacrine was once used in the treatment of Alzheimer's disease, but it is no longer commonly prescribed due to safety concerns and the availability of newer, safer medications. It is not indicated for Parkinson's disease.
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