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

Answer and Explanation

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.

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Correct Answer is ["A","D"]

Explanation

A. Acetaminophen

Acetaminophen is a non-opioid analgesic that can be used for mild to moderate pain relief. It is suitable for managing pain associated with abrasions.

B. Aspirin

Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) with analgesic and anti-inflammatory properties. While it can be used for pain relief, it may increase the risk of bleeding, and its use is generally avoided in acute injuries with bleeding.

C. Hydrocodone

Hydrocodone is an opioid analgesic and is typically reserved for moderate to severe pain. It may not be the first choice for managing pain associated with abrasions unless the pain is more intense.

D. Ibuprofen

Ibuprofen is a NSAID that provides analgesic and anti-inflammatory effects. It is suitable for managing pain and inflammation associated with abrasions.

E. Morphine

Morphine is a strong opioid analgesic and is generally reserved for severe pain, such as post-surgical pain or pain associated with more significant injuries. It may be excessive for managing pain from abrasions.

A. as requested by the patient. B. 1 hour after chemotherapy administration. C. The night before the treatment, the day of the treatment, and for 24 hours after the treatment. D. the day of treatment.

Correct Answer is C

Explanation

A. As requested by the patient.

Administering the drug only when requested by the patient may not provide adequate prophylaxis against chemotherapy-induced nausea and vomiting. These medications are often prescribed on a schedule to prevent symptoms rather than treating them reactively.

B. 1 hour after chemotherapy administration.

Waiting until 1 hour after chemotherapy administration may not cover the full period during which nausea and vomiting are likely to occur. The administration schedule for antiemetics is often more extended to provide better coverage.

C. The night before the treatment, the day of the treatment, and for 24 hours after the treatment.

This is the correct choice. Administering phenothiazine antiemetics according to this schedule helps ensure continuous coverage during the critical period when chemotherapy-induced nausea and vomiting are most likely to occur.

D. The day of treatment.

Administering the drug only on the day of treatment may not provide sufficient coverage for the entire duration when chemotherapy-induced nausea and vomiting can occur. Again, the schedule mentioned in option C is more comprehensive for prevention.

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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?

Nursing Test Bank

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The client has fallen off his mountain bike and sustained multiple abrasions to both of his knees. Which would be appropriate medication(s) for pain management for this client? (Select All That Apply)

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