Which information about a patient who has a new prescription for phenytoin (Dilantin) indicates that the nurse should consult with the health care provider before administration of the medication?

Patient has slight elevations in liver function test results

Patient's most recent blood pressure is 156/92 mm Hg.

Patient experiences an aura before seizures.

Patient has tonic-clonic seizures.

Answer and Explanation

The Correct Answer is A

A. Patient has slight elevations in liver function test results: Phenytoin is primarily metabolized by the liver, and elevated liver function tests may indicate impaired liver function, potentially affecting the metabolism and clearance of phenytoin. Consultation with the healthcare provider is warranted to assess the risk-benefit ratio of administering phenytoin in the presence of liver function abnormalities.

B. Patient's most recent blood pressure is 156/92 mm Hg: While hypertension is not a contraindication for phenytoin administration, it is important to monitor blood pressure, especially considering the potential cardiovascular side effects of the medication. However, elevated blood pressure alone does not typically warrant consultation before administering phenytoin.

C. Patient experiences an aura before seizures: Experiencing an aura before seizures is a common phenomenon in patients with epilepsy and does not necessarily contraindicate the use of phenytoin. In fact, phenytoin is commonly prescribed to prevent seizures, including those preceded by an aura.

D. Patient has tonic-clonic seizures: Phenytoin is indicated for the treatment and prevention of tonic-clonic seizures, among other seizure types. Therefore, the presence of tonic-clonic seizures would not typically warrant consultation before administering phenytoin.

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Correct Answer is B

Explanation

A. Oral Levetiracetam: Oral medications are not appropriate for immediate seizure management during an active seizure. Intravenous medications are typically used for acute seizure management.

B. IV Lorazepam: Lorazepam is a benzodiazepine that is commonly used as a first-line medication for terminating acute seizures. It acts quickly to suppress seizure activity and is often administered intravenously during a seizure episode.

C. IV Ondansetron: Ondansetron is an antiemetic medication used to prevent nausea and vomiting and is not indicated for seizure management.

D. Magnesium Sulfate: Magnesium sulfate is not typically used for seizure management in the acute setting. It may be used for certain types of seizures or as a treatment for eclampsia, but it is not a first-line medication for acute seizure termination.

A. Paraplegia B. Paresthesia C. Quadriplegia D. Hemiplegia

Correct Answer is A

Explanation

A. Paraplegia: Paraplegia is the paralysis of the lower extremities and possibly the trunk, which can occur with a spinal cord injury at the level of the T2-T3 vertebrae.

B. Paresthesia: Paresthesia refers to abnormal sensations such as tingling or numbness and is not typically associated with a spinal cord injury at the T2-T3 level. It may occur with nerve damage but is not the primary disability anticipated in this scenario.

C. Quadriplegia: Quadriplegia, also known as tetraplegia, involves paralysis of all four limbs and the trunk. It is more commonly associated with injuries at higher levels of the spinal cord, such as cervical injuries.

D. Hemiplegia: Hemiplegia involves paralysis of one side of the body and is typically caused by a stroke or brain injury, not a spinal cord injury at the T2-T3 level.

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Which information about a patient who has a new prescription for phenytoin (Dilantin) indicates that the nurse should consult with the health care provider before administration of the medication?

Nursing Test Bank

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