A nurse is preparing to administer phenytoin 50 mg IV bolus to a client Who has a seizure disorder. The medication is supplied as a 50 mg/mL vial. Which of the following actions should the nurse take?

Dilute the medication with sterile water before injecting.

Administer the medication over 1 min.

Follow the IV injection with sterile water.

Slow the injection if the medication crystallizes.

Answer and Explanation

The Correct Answer is B

A.   Diluting phenytoin with sterile water before injecting is not recommended, as phenytoin is incompatible with most used diluents. Diluting it can lead to precipitation and potentially cause adverse effects such as tissue irritation and phlebitis.
B.   Administering the medication over 1 min is recommended. Phenytoin should be administered at a rate of 50mg/min.
C.   Following the IV injection with sterile water is unnecessary and not indicated for administering phenytoin.
D. Phenytoin precipitates out of solution when mixed with certain diluents or when administered too quickly. Crystallized phenytoin can cause local irritation, tissue damage, and potentially more serious adverse effects. Therefore, it should not be administered at all.

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Correct Answer is C

Explanation

alcohol consumption affects liver metabolism due to injury to the hepatic parenchyma. Impairment of liver function interferes with the metabolism and clearance of phenytoin leading to increased risk of adverse effects.

A-antacids should be avoided as they decrease the absorption of phenytoin

B flossing teeth is important for maintaining oral hygiene reducing the risk of oral complications of phenytoin-induced gingival hyperplasia

D phenytoin does not cause changes in urine color

A. Freeze unopened insulin vials. B. Shake the insulin vigorously before loading the syringe. C. Discard the NPH solution if it appears cloudy. D. Expect the NPH insulin to peak in 6 to 14 hr.

Correct Answer is D

Explanation

NPH Insulin is an intermediate acting insulin with a peak at 6-14hrs
A. Freezing unopened insulin vials is not recommended, as freezing can denature the insulin and affect its potency. Insulin should be stored in the refrigerator but should not be frozen
B. The insulin should be rotated of rolled between palms to allow for proper mixing before drawing.
Shaking vigorously promotes bubble formation
C. NPH insulin has a normal turbid appearance at neutral pH

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A nurse is preparing to administer phenytoin 50 mg IV bolus to a client Who has a seizure disorder. The medication is supplied as a 50 mg/mL vial. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has seizures and a new prescription for phenytoin. Which of the following information should the nurse provide?

Correct Answer is C

Explanation

A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if her blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?

Correct Answer is D

Explanation

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