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Zorluk: OrtaPharmacological and Parenteral Therapies

A nurse is caring for a client who is actively experiencing status epilepticus. The healthcare provider prescribes phenytoin IV push. The client has an existing continuous peripheral IV infusion of 5% dextrose in water (D5W) infusing at 100 mL/hr. Which action should the nurse take?

  1. Stop the D5W infusion, flush the line with 0.9% sodium chloride, administer the phenytoin, and flush again with 0.9% sodium chloride.Cevap
  2. B
    Administer the phenytoin via the Y-site port closest to the client while the D5W continues to infuse.
  3. C
    Administer the medication rapidly via IV push at a rate of 100 mg/minute to immediately halt the seizure activity.
  4. D
    Prioritize obtaining a detailed neurological history from the family before preparing the medication.

Cevap

Stop the D5W infusion, flush the line with 0.9% sodium chloride, administer the phenytoin, and flush again with 0.9% sodium chloride.
Phenytoin is physically incompatible with solutions containing dextrose (such as D5W) and will precipitate if they come into contact. To safely administer the medication through the same IV line, the nurse must temporarily stop the continuous D5W infusion and flush the line with a compatible solution, specifically 0.9% sodium chloride (normal saline), both before and after the phenytoin is given.

Adım Adım Çözüm

1
Identify the primary IV fluid.
The client is receiving 5% dextrose in water (D5W).
Knowing the primary fluid is necessary to verify medication compatibility.
2
Verify the compatibility of the prescribed IV medication with the primary fluid.
Phenytoin is physically incompatible with dextrose solutions and will form a solid precipitate if mixed.
Administering incompatible medications can cause crystallization, leading to loss of IV access or a life-threatening embolism.
3
Determine the correct administration technique for the incompatible medication.
The continuous infusion must be paused, and the line must be flushed with a compatible solution (0.9% sodium chloride) before and after the phenytoin is administered.
Flushing clears the line of the incompatible fluid, ensuring safe delivery of the medication.

Anahtar Kavram

Phenytoin is physically incompatible with dextrose solutions and must be administered using 0.9% sodium chloride to prevent precipitation.
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Pharmacological and Parenteral Therapies

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