The nurse is working on a neurosurgery unit. The patient calls the desk to complain that his arm is really burning and feels hot. The patient is receiving IV phenytoin for his grand mal seizures. What is the nurse's best action?

Call the health carer provider immediately to change the medication to oral.

Continue the infusion and reassure the patient.

Flush the line with 10 mL of normal saline and continue the infusion.

Discontinue the IV and restart the IV infusion in a different site

Answer and Explanation

The Correct Answer is D

A. Call the health care provider immediately to change the medication to oral.

Changing the medication to oral may not address the immediate issue of the burning sensation and feeling of heat at the IV site. This option focuses on changing the route of administration rather than addressing the current discomfort.

B. Continue the infusion and reassure the patient.

Continuing the infusion without addressing the patient's discomfort could lead to potential complications, and it is important to prioritize patient comfort and safety. Reassurance alone may not be sufficient if there is an issue with the IV site.

C. Flush the line with 10 mL of normal saline and continue the infusion.

While flushing the line with normal saline is a good practice to ensure patency, it may not resolve the issue if there is ongoing irritation or infiltration at the site. Continuing the infusion without addressing the patient's complaint might lead to further discomfort.

D. Discontinue the IV and restart the IV infusion in a different site.

This is the best action. Discontinuing the IV allows the nurse to assess the current site for signs of infiltration or irritation. Restarting the IV in a different site addresses the immediate issue, ensuring that the medication is delivered safely and effectively.

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Correct Answer is B

Explanation

A. "Continue taking OCPS because phenytoin is not safe during pregnancy."

This statement is not accurate. While it's essential to address pregnancy risk, phenytoin can reduce the effectiveness of oral contraceptives. Women on phenytoin are often advised to use additional contraceptive measures.

B. "You should use a backup method of contraception along with OCPs."

This is the correct response. Phenytoin can accelerate the metabolism of oral contraceptives, potentially reducing their effectiveness. Using a backup method, such as condoms, is recommended to ensure adequate contraception.

C. "You should stop taking OCPs because of drug-drug interactions with phenytoin."

This advice is generally not recommended without consulting the healthcare provider. Abruptly stopping OCPs without an alternative form of contraception can increase the risk of unintended pregnancy.

D. "You should take low-dose aspirin while taking these medications to reduce your risk of stroke."

This statement is not relevant to the situation described. Low-dose aspirin is not typically recommended for contraception, and its use in this context does not address the potential interaction between phenytoin and oral contraceptives.

A. "I may experience urinary retention, dry mouth, and constipation." B. "I may feel dizzy at first, but this side effect will go away with time." C. "I should report nightmares and mental disturbances to my provider." D. "I should take the drug with food to increase absorption."

Correct Answer is D

Explanation

A. "I may experience urinary retention, dry mouth, and constipation."

This statement is accurate. Urinary retention, dry mouth, and constipation are common side effects of carbidopa-levodopa. The patient should be aware of these potential side effects and report them to the healthcare provider if they become problematic.

B. "I may feel dizzy at first, but this side effect will go away with time."

This statement is accurate. Dizziness is a common initial side effect of carbidopa-levodopa, and it often improves with continued use. The patient should be encouraged to report persistent dizziness to the healthcare provider.

C. "I should report nightmares and mental disturbances to my provider."

This statement is accurate. Nightmares and mental disturbances can be side effects of carbidopa-levodopa. The patient should report these symptoms to the healthcare provider for further evaluation and potential adjustments to the medication.

D. "I should take the drug with food to increase absorption."

This statement indicates a need for further teaching. Carbidopa-levodopa is best absorbed when taken on an empty stomach. Taking it with food, especially high-protein meals, can reduce its absorption. The patient should be instructed to take the medication at least 30 minutes before meals or one to two hours after meals for optimal effectiveness.

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The nurse is working on a neurosurgery unit. The patient calls the desk to complain that his arm is really burning and feels hot. The patient is receiving IV phenytoin for his grand mal seizures. What is the nurse's best action?

Nursing Test Bank

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