A client is prescribed a scheduled dose of intravenous (IV) phenytoin to manage seizure activity. The client currently has a continuous peripheral IV infusion of 5% dextrose in water (D5W) infusing. Which action must the nurse implement to administer this medication safely?
- Flush the intravenous line with 0.9% sodium chloride before and after the administration.Answer
- BAdminister the medication directly into the lowest Y-port while the continuous infusion remains running.
- CPush the medication rapidly over 15 to 30 seconds to ensure a quick onset of therapeutic action.
- DDilute the medication in a syringe with 10 mL of sterile water prior to injecting it into the line.
Answer
The correct action is to flush the intravenous line with 0.9% sodium chloride before and after administering the medication.
Phenytoin is highly incompatible with dextrose-containing solutions such as 5% dextrose in water (D5W). If mixed, the medication will quickly precipitate and form crystals. To safely administer the drug through the existing intravenous line, the nurse must clear the dextrose from the tubing by flushing it with a compatible solution—specifically 0.9% sodium chloride (normal saline)—both before and immediately after the medication push.
Step-by-Step Solution
Key Concept
Intravenous medication compatibility and safe administration principles.