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 C
Explanation
A. "I need to increase my fluid intake." - This is a correct statement. Sucralfate should be taken with plenty of water to ensure proper absorption and effectiveness.
B. "I need to report pain or vomiting of blood." - This is also a correct statement. Severe abdominal pain or vomiting of blood may indicate a serious issue and should be reported to the healthcare provider.
C. "I need to take Carafate 30 minutes after meals." - This is an incorrect statement. Sucralfate is typically taken on an empty stomach, about 1 hour before meals and at bedtime.
D. "I need to take Maalox 30 minutes before or after Carafate." - This statement is correct. Antacids like Maalox can interfere with the absorption of sucralfate. It's generally recommended to space them apart, taking sucralfate at least 30 minutes before or after antacids.
Correct Answer is ["2"]
Explanation
To calculate the dose of fluconazole for a child who weighs 44 pounds, you need to convert the weight to kilograms and the dose to milligrams.
One kilogram is equal to 2.2 pounds, so 44 pounds is 44 / 2.2 = 20 kilograms.
The dose of fluconazole is 5 mg/kg, so 5 mg x 20 kg = 100 mg.
The label on the bottle says that each tablet contains 50 mg of fluconazole, so you need to divide the dose by the tablet strength to get the number of tablets. 100 mg / 50 mg = 2 tablets.
Therefore, you should administer two tablets of fluconazole once a day for this child.
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