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.
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
Rifampin causes harmless discoloration of bodily fluids, including urine, sweat, saliva, and tears, to an orange-red color. Other side effects include gastrointestinal side effects such as nausea, vomiting, and diarrhea.
A. Rifampin should be taken on an empty stomach, as food can interfere with its absorption.
B. Insomnia is not a common side effect of rifampin
D. Treatment for tuberculosis goes on for at least 6 to 9 months. Treatment duration varies depending on the specific regimen and the severity of the infection.
Correct Answer is B
Explanation
It is recommended that every injection of phenytoin be followed by infusion of at least 50 to 100mls of normal saline infusion. This is important to prevent local irritation that occurs as surrounding tissues react to the medication.
A. Mixing phenytoin in dextrose 5% is not recommended due risk of precipitation of the Phenytoin acid
C. Phenytoin should be given at a date of 50mg/min or less to reduce the risk of toxicity
D. The injection should not be held as it is used to manage the seizure unless it is not safe for the nurse to give it
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