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. Avoid caffeine-containing beverages before sleep
The highest priority teaching point to help relieve sleeplessness would be to advise the client to avoid caffeine-containing beverages before sleep. Caffeine is a stimulant that can interfere with the ability to fall asleep and maintain a restful sleep.
B. Perform strenuous exercise before bedtime
Strenuous exercise close to bedtime can actually stimulate the body and make it more difficult for the individual to relax and fall asleep. It is generally recommended to engage in exercise earlier in the day.
C. Drink lots of fluids before bedtime
Drinking excessive fluids before bedtime may lead to disrupted sleep as it can increase the need to wake up for bathroom trips during the night. It's advisable to limit fluid intake close to bedtime.
D. Eat a heavy meal before bedtime
Consuming a heavy meal before bedtime can cause discomfort and indigestion, potentially disrupting sleep. It is recommended to have a light, easily digestible meal if eating close to bedtime.
Correct Answer is C
Explanation
A. Antacids and narcotics.
Antacids can provide temporary relief of symptoms, but they do not treat the underlying H. pylori infection. Narcotics are not typically used as a standard treatment for peptic ulcer disease related to H. pylori.
B. Pepsin inhibitors and antiemetics.
Pepsin inhibitors and antiemetics may address symptoms but do not target the H. pylori infection directly. The standard treatment involves antibiotics to eradicate the bacteria and proton pump inhibitors to reduce acid production.
C. Proton pump inhibitors and antibiotics.
A positive breath test for H. pylori indicates the presence of Helicobacter pylori bacteria, which is associated with peptic ulcer disease. The standard treatment for H. pylori infection involves a combination of proton pump inhibitors (to reduce stomach acid production) and antibiotics (to eradicate the bacteria).
D. Emetic agents and tranquilizers.
Emetic agents are used to induce vomiting and are not indicated for the treatment of H. pylori infection. Tranquilizers are not part of the standard treatment for peptic ulcer disease associated with H. pylori.
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