A client who is unresponsive following a traumatic brain injury is receiving continuous enteral feedings via a gastrostomy tube. The health care provider prescribes scheduled liquid oral phenytoin for seizure prophylaxis. The practical nurse is preparing to administer the medication. Which action should the nurse take?
- ADelegate the administration of the oral medication to an unlicensed assistive personnel while assessing the client's neurological status.
- BCalculate a reduced medication volume and administer it concurrently with the feeding formula to prevent gastrointestinal upset.
- Stop the continuous enteral feeding for 1 to 2 hours before administering the phenytoin dose.Answer
- DDraw up the liquid medication and administer it immediately without checking identifiers since the client cannot respond.
Answer
The correct action is to pause the continuous enteral feeding for 1 to 2 hours prior to administering the liquid phenytoin.
The correct action is to pause the continuous enteral feeding for 1 to 2 hours before administering the medication. Enteral feeding formulas significantly decrease the absorption of oral phenytoin in the gastrointestinal tract. If the feeding is not paused, the client may develop subtherapeutic phenytoin levels, increasing the risk of breakthrough seizures. The feeding should also remain paused for 1 to 2 hours after administration to allow for complete drug absorption.
Step-by-Step Solution
Key Concept
Phenytoin Administration with Enteral Feedings