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 ["540"]
Explanation
The client consumes three different types of fluids during the day: milk, juice, and soup. The amount of each fluid is measured in different units: cups, ounces, and bowls. To record the client's intake in milliliters (mL), we need to convert these units using the following conversion factors:
- 1 cup = 240 mL
- 1 ounce = 30 mL
- 1 bowl = 150 mL
Using these conversion factors, we can calculate the client's intake in mL as follows:
- Milk: 1 cup x 240 mL/cup = 240 mL
- Juice: 4 oz. x 30 mL/oz. = 120 mL
- Soup: 6 oz. x 30 mL/oz. = 180 mL
The total intake in mL is the sum of these three values:
- Total intake = 240 mL + 120 mL + 180 mL = 540 mL
Therefore, the client's intake in mL is 540 mL.
Correct Answer is ["2"]
Explanation
Each tablet contains 8 mg of the active ingredient, candesartan. The physician has ordered 16 mg of Atacand, which means you need to give two tablets. You can use this formula to find the number of tablets:
Number of tablets = Ordered dose / Tablet strength
Number of tablets = 16 mg / 8 mg
Number of tablets = 2
Therefore, you would administer two tablets of Atacand to the patient.
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