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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Increase the amount of dopamine and reduce the amount of acetylcholine:
This is the correct answer. Parkinson's disease is characterized by a deficiency of dopamine, so medications aim to increase dopamine levels. Additionally, reducing the activity of acetylcholine helps to restore the balance between these neurotransmitters.
B. Increase the amount of dopamine and acetylcholine:
This is not accurate. Increasing both dopamine and acetylcholine would not address the underlying imbalance seen in Parkinson's disease.
C. Reduce the amount of dopamine and increase the amount of acetylcholine:
This is incorrect. Parkinson's disease involves a reduction in dopamine levels, so reducing dopamine further would worsen the symptoms. Additionally, increasing acetylcholine is not the therapeutic goal in Parkinson's disease.
D. Reduce the amount of dopamine and acetylcholine:
This is not the correct approach. Decreasing both dopamine and acetylcholine would exacerbate the symptoms of Parkinson's disease, as the primary issue is the deficiency of dopamine.
Correct Answer is A
Explanation
A. Diazepam
For the treatment of status epilepticus, the drug of choice is typically a benzodiazepine, and diazepam is commonly used. Diazepam is a fast-acting anticonvulsant that can be administered intravenously to rapidly terminate seizures during status epilepticus.
B. Midazolam
Midazolam is another benzodiazepine that can be used for the treatment of status epilepticus, particularly when intravenous access is difficult. It can be administered intramuscularly or intranasally.
C. Valproic Acid
Valproic acid is an anticonvulsant, but it is not typically the first-line choice for the acute treatment of status epilepticus. It may be considered if benzodiazepines are not effective.
D. Carbamazepine
Carbamazepine is not used for the acute treatment of status epilepticus. It is more commonly used as a maintenance therapy for epilepsy.
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