While working in the emergency department, a registered nurse receives a prescription for a stat dose of intravenous phenytoin for a client experiencing seizure activity. The client's only venous access is a peripheral catheter currently infusing dextrose in water () at . Which protocol must the nurse implement to safely administer this medication?
- AIntroduce the medication directly into the running dextrose infusion to promote steady systemic absorption.
- BDeliver the medication rapidly over a period to promptly achieve therapeutic serum levels.
- Flush the intravenous catheter with normal saline both prior to and following the medication injection.Answer
- DDelegate the task of checking the client's vital signs every to an unlicensed assistive personnel.
Answer
The nurse must clear the intravenous line by flushing it with normal saline before and after the phenytoin administration.
Phenytoin is highly incompatible with dextrose-containing solutions such as . If mixed, the medication will rapidly form a solid precipitate. To prevent this dangerous crystallization and ensure safe delivery, the nurse must clear the tubing by flushing it with a compatible solution—specifically normal saline—both before and after the medication is administered.
Step-by-Step Solution
Key Concept
Phenytoin is physically incompatible with dextrose-containing solutions and requires flushing the intravenous line with normal saline to prevent dangerous precipitation.