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. 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.
Correct Answer is A
Explanation
A. Carbidopa-levodopa
The symptoms described, including a shuffling gait, lack of facial expression, and tremors at rest, are characteristic of Parkinson's disease. Carbidopa-levodopa is a common medication used in the management of Parkinson's disease.
B. Donepezil
Donepezil is used in the treatment of Alzheimer's disease, a condition characterized by cognitive decline and memory impairment. It is not indicated for Parkinson's disease.
C. Rivastigmine
Rivastigmine is another medication used in the treatment of Alzheimer's disease, and it is also used in Parkinson's disease dementia. However, it is not the primary medication for the motor symptoms of Parkinson's disease.
D. Tacrine
Tacrine was once used in the treatment of Alzheimer's disease, but it is no longer commonly prescribed due to safety concerns and the availability of newer, safer medications. It is not indicated for Parkinson's disease.
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