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 A

Explanation

Fat overload syndrome is a rare but serious complication that can occur in clients receiving lipid infusion. It is typically characterized by fever.

Although spontaneous hemorrhage can occur, peripheral edema is not a typical feature of fat overload syndrome.

Hypertension is not a typical feature of fat overload syndrome. However, hypotension may occur due to fluid shift and vasodilation.

Erythema can occur at the site of infusion during lipid infusion. However, it is not a typical feature of fat overload syndrome.

A. Document that the client experienced an anaphylactic reaction to the medication. B. Decrease the infusion rate on the IV. C. Apply cold compresses to the neck area. D. Change the IV infusion site.

Correct Answer is B

Explanation

A. The symptoms described (flushing and tachycardia) are not indicative of an anaphylactic reaction, which typically includes symptoms like difficulty breathing, hives, or swelling. Documenting it as an anaphylactic reaction would be misleading and could lead to inappropriate management.
B. Slowing the infusion rate can help mitigate the symptoms of Red Man Syndrome, which is often related to the rate of vancomycin administration. The recommended infusion rate for vancomycin is generally over at least 60 minutes, and reducing the rate can help alleviate symptoms.
C. Applying cold compresses should help with pain but as important like documentation.
D. The infusion should be continued and not used again for the client.

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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 assessing a client who is receiving a parental lipid infusion. Which of the following findings is a manifestation of fat overload syndrome?

Correct Answer is A

Explanation

A nurse is assessing a client who is receiving IV vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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