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

Following traumatic brain injury, the cerebral tissues undergoes an inflammatory process in response to the trauma leading to brain edema. This increases intracranial pressure which presents with features such as seizures, headaches and other focal neurological deficits. Mannitol is an osmotic diuretic that works by drawing water out of brain tissue and into the bloodstream, thereby reducing cerebral edema and intracranial pressure.
B, C, D have no role in raised intracranial pressure

A. Bladder spasms B. Frequent episodes of painful urination C. Severe pain. D. Inability to void

Correct Answer is D

Explanation

Bethanechol is a cholinergic agonist used to stimulate contraction of the bladder to help in the expulsion of urine. It is used in the management of urinary retention by promoting bladder emptying. Therefore, it should be administered when the client reports an inability to void, as this indicates urinary retention
A. Bladder spasms are treated with Oxybutynin
B. Frequent painful urination is a feature of UTI requiring antibiotics
C. Bethanechol has no analgesic property

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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

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Correct Answer is A

Explanation

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Correct Answer is D

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